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Verheugt FWA, Fox KAA, Virdone S, Ambrosio G, Gersh BJ, Haas S, Pieper KS, Kayani G, Camm AJ, Parkhomenko A, Misselwitz F, Ragy H, Ten Cate H, Keltai M, Kakkar AK. Outcomes of Oral Anticoagulation in Atrial Fibrillation Patients With or Without Comorbid Vascular Disease: Insights From the GARFIELD-AF Registry. Am J Med 2023; 136:1187-1195.e15. [PMID: 37704071 DOI: 10.1016/j.amjmed.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/07/2023] [Accepted: 08/11/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Many patients with atrial fibrillation suffer from comorbid vascular disease. The comparative efficacy and safety of different types of oral anticoagulation (OAC) in this patient group have not been widely studied. METHODS Adults with newly diagnosed atrial fibrillation were recruited into the prospective observational registry, GARFIELD-AF, and followed for 24 months. Associations of vascular disease with clinical outcomes were analyzed using adjusted hazard ratios (HR) obtained via Cox proportional-hazard modeling. Outcomes of OAC vs no OAC, and of non-vitamin K antagonist OAC (NOAC) vs vitamin K antagonist (VKA) treatment, were compared by overlap propensity-weighted Cox proportional-hazard models. RESULTS Of 51,574 atrial fibrillation patients, 25.9% had vascular disease. Among eligible atrial fibrillation patients, those with vascular disease received OAC less frequently than those without (63% vs 73%). Over 2-year follow-up, patients with vascular disease showed a higher risk of all-cause mortality (HR 1.30; 95% confidence interval [CI], 1.16-1.47) and cardiovascular mortality (HR 1.59; 95% CI, 1.28-1.97). OAC was associated with a significant decrease in all-cause mortality and non-hemorrhagic stroke, and increased risk of major bleeding in non-vascular disease. In vascular disease, similar but non-significant trends existed for stroke and major bleeding. A significantly lower risk of all-cause mortality (HR 0.74; 95% CI, 0.61-0.90) and major bleeding (HR 0.45; 95% CI, 0.29-0.70) was observed in vascular disease patients treated with NOACs, compared with VKAs. CONCLUSIONS Atrial fibrillation patients with a history of vascular disease have worse long-term outcomes than those without. The association of NOACs vs VKA with clinical outcomes was more evident in atrial fibrillation patients with vascular disease.
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Affiliation(s)
| | - Keith A A Fox
- Centre for Cardiovascular Science, University of Edinburgh, UK
| | | | - Giuseppe Ambrosio
- Division of Cardiology, University of Perugia School of Medicine Cardiology, Italy
| | - Bernard J Gersh
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minn, USA
| | - Sylvia Haas
- [Formerly] Department of Medicine, Technical University of Munich, Germany
| | | | | | - A John Camm
- Cardiology Clinical Academic Group Molecular & Clinical Sciences Research Institute, St. George's University of London, UK
| | - Alexandr Parkhomenko
- National Scientific Centre "MD Strazhesko Institute of Cardiology", Kyiv, Ukraine
| | | | - Hany Ragy
- Department of Cardiology, National Heart Institute, Cairo, Egypt
| | - Hugo Ten Cate
- Maastricht University Medical Center (MUMC+) and Cardiovascular Research Institute (CARIM), Maastricht University, Netherlands; Center for Thrombosis and Hemostasis (CTH), Gutenberg University Medical Center, Mainz, Germany
| | - Matyas Keltai
- Semmelweis University, Hungarian Cardiovascular Institute, Budapest, Hungary
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2
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Bassand JP, Virdone S, Camm AJ, Fox KAA, Goldhaber SZ, Goto S, Haas S, Hacke W, Kayani G, Keltai M, Misselwitz F, Pieper KS, Turpie AGG, Verheugt FWA, Kakkar AK. Oral anticoagulation across diabetic subtypes in patients with newly diagnosed atrial fibrillation: A report from the GARFIELD-AF registry. Diabetes Obes Metab 2023; 25:3040-3053. [PMID: 37435777 DOI: 10.1111/dom.15202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/16/2023] [Accepted: 06/16/2023] [Indexed: 07/13/2023]
Abstract
AIMS This study aims to describe both management and prognosis of patients with diabetes mellitus (DM) and newly diagnosed atrial fibrillation (AF), overall as well as by antidiabetic treatment, and to assess the influence of oral anticoagulation (OAC) on outcomes by DM status. METHODS The study population comprised 52 010 newly diagnosed patients with AF, 11 542 DM and 40 468 non-DM, enrolled in the GARFIELD-AF registry. Follow-up was truncated at 2 years after enrolment. Comparative effectiveness of OAC versus no OAC was assessed by DM status using a propensity score overlap weighting scheme and weights were applied to Cox models. RESULTS Patients with DM [39.3% oral antidiabetic drug (OAD), 13.4% insulin ± OAD, 47.2% on no antidiabetic drug] had higher risk profile, OAC use, and rates of clinical outcomes compared with patients without DM. OAC use was associated in patients without DM and patients with DM with lower risk of all-cause mortality [hazard ratio 0.75 (0.69-0.83), 0.74 (0.64-0.86), respectively] and stroke/systemic embolism (SE) [0.69 (0.58-0.83), 0.70 (0.53-0.93), respectively]. The risk of major bleeding with OAC was similarly increased in patients without DM and those with DM [1.40 (1.14-1.71), 1.37 (0.99-1.89), respectively]. Patients with insulin-requiring DM had a higher risk of all-cause mortality and stroke/SE [1.91 (1.63-2.24)], [1.57 (1.06-2.35), respectively] compared with patients without DM, and experienced significant risk reductions of all-cause mortality and stroke/SE with OAC [0.73 (0.53-0.99); 0.50 (0.26-0.97), respectively]. CONCLUSIONS In both patients with DM and patients without DM with AF, OAC was associated with lower risk of all-cause mortality and stroke/SE. Patients with insulin-requiring DM derived significant benefit from OAC.
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Affiliation(s)
- Jean-Pierre Bassand
- University of Besançon Franche-Comté, Besançon, France
- Thrombosis Research Institute, London, UK
| | | | - A John Camm
- Cardiology Clinical Academic Group Molecular & Clinical Sciences Institute, St. George's University of London, London, UK
| | - Keith A A Fox
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Samuel Z Goldhaber
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Shinya Goto
- Tokai University School of Medicine, Kanagawa, Japan
| | - Sylvia Haas
- Formerly Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | | | | | - Matyas Keltai
- Hungarian Cardiovascular Institute, Semmelweis University, Budapest, Hungary
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3
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Eikelboom JW, Bosch J, Connolly SJ, Tyrwitt J, Fox KAA, Muehlhofer E, Neumann C, Tasto C, Bangdiwala SI, Diaz R, Alings M, Dagenais GR, Leong DP, Lonn EM, Avezum A, Piegas LS, Widimsky P, Parkhomenko AN, Bhatt DL, Branch KRH, Probstfield JL, Lopez-Jaramillo P, Rydén L, Pogosova N, Keltai K, Keltai M, Ertl G, Stoerk S, Dans AL, Lanas F, Liang Y, Zhu J, Torp-Pedersen C, Maggioni AP, Commerford PJ, Guzik TJ, Vanassche T, Verhamme P, O'Donnell M, Tonkin AM, Varigos JD, Vinereanu D, Felix C, Kim JH, Ibrahim KS, Lewis BS, Metsarinne KP, Aboyans V, Steg PG, Hori M, Kakkar A, Anand SS, Lamy A, Sharma M, Yusuf S. Long-Term Treatment with the Combination of Rivaroxaban and Aspirin in Patients with Chronic Coronary or Peripheral Artery Disease: Outcomes During the Open Label Extension of the COMPASS trial. Eur Heart J Cardiovasc Pharmacother 2022; 8:786-795. [PMID: 35383832 DOI: 10.1093/ehjcvp/pvac023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/13/2022] [Accepted: 03/31/2022] [Indexed: 12/29/2022]
Abstract
AIMS To describe outcomes of patients with chronic coronary artery disease (CAD) and/or peripheral artery disease (PAD) enrolled in the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) randomized trial who were treated with the combination of rivaroxaban 2.5 mg twice daily and aspirin 100 mg once daily during long-term open-label extension (LTOLE). METHODS AND RESULTS Of the 27 395 patients enrolled in COMPASS, 12 964 (mean age at baseline 67.2 years) from 455 sites in 32 countries were enrolled in LTOLE and treated with the combination of rivaroxaban and aspirin for a median of 374 additional days (range 1-1191 days). During LTOLE, the incident events per 100 patient years were as follows: for the primary outcome [cardiovascular death, stroke, or myocardial infarction (MI)] 2.35 [95% confidence interval (CI) 2.11-2.61], mortality 1.87 (1.65-2.10), stroke 0.62 (0.50-0.76), and MI 1.02 (0.86-1.19), with CIs that overlapped those seen during the randomized treatment phase with the combination of rivaroxaban and aspirin. The incidence rates for major and minor bleeding were 1.01 (0.86-1.19) and 2.49 (2.24-2.75), compared with 1.67 (1.48-1.87) and 5.11 (95% CI 4.77-5.47), respectively, during the randomized treatment phase with the combination. CONCLUSION In patients with chronic CAD and/or PAD, extended combination treatment for a median of 1 year and a maximum of 3 years was associated with incidence rates for efficacy and bleeding that were similar to or lower than those seen during the randomized treatment phase, without any new safety signals.
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Affiliation(s)
- John W Eikelboom
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton Canada
| | - Jacqueline Bosch
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Stuart J Connolly
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton Canada
| | - Jessica Tyrwitt
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton Canada
| | - Keith A A Fox
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Eva Muehlhofer
- Bayer AG Pharmaceuticals, Research & Development, Wuppertal, Germany
| | - Christoph Neumann
- Bayer AG Pharmaceuticals, Research & Development, Wuppertal, Germany
| | - Christoph Tasto
- Bayer AG Pharmaceuticals, Research & Development, Wuppertal, Germany
| | - Shrikant I Bangdiwala
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton Canada
| | - Rafael Diaz
- Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosaria, Argentina
| | - Marco Alings
- Division of Cardiology, Amphia ziekenhuis, Breda, Netherlands and Werkgroep Cardiologische centra Nederland (WCN), Utrecht, the Netherlands
| | - Gilles R Dagenais
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada
| | - Darryl P Leong
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton Canada
| | - Eva M Lonn
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton Canada
| | - Alvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | | | - Petr Widimsky
- Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alexander N Parkhomenko
- Emergency Cardiology Dept., National Scientific Center Institute of Cardiology, Kyiv, Ukraine
| | - Deepak L Bhatt
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kelley R H Branch
- University of Washington Medical Centre, Division of Cardiology, Seattle, WA, USA
| | - Jeffrey L Probstfield
- University of Washington SOM, Division of Cardiology/Department of Medicine, Seattle WA, USA
| | - Patricio Lopez-Jaramillo
- Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia
| | - Lars Rydén
- Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden
| | - Nana Pogosova
- National Medical Research Center of Cardiology, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Katalin Keltai
- Hungarian Cardiovascular Institute, Semmelweis University, Budapest, Hungary
| | - Matyas Keltai
- Hungarian Cardiovascular Institute, Semmelweis University, Budapest, Hungary
| | - Georg Ertl
- Deutsches Zentrum für Herzinsuffizienz, Medizinische Klinik I, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Stefan Stoerk
- Deutsches Zentrum für Herzinsuffizienz, Medizinische Klinik I, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Antonio L Dans
- College of Medicine, University of Philippines, Manila, Philippines
| | - Fernando Lanas
- Universidad de La Frontera, Division of Cardiology, Internal Medicine Department, Temuco, Chile
| | - Yan Liang
- Fuwai Hospital, CAMS & PUMC, Beijing, China
| | - Jun Zhu
- Dept of Clinical Medicine, University of Aalborg, Copenhagen, Denmark
| | | | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Patrick J Commerford
- Division of Cardiology, Department of Medicine, Groote Schuur Hospital and the University of Cape Town, Cape Town, South Africa
| | - Tomasz J Guzik
- Department of Medicine, Jagiellonian University Medical College Krakow, Poland.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Thomas Vanassche
- Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium
| | - Peter Verhamme
- Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium
| | | | - Andrew M Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - John D Varigos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Dragos Vinereanu
- University of Medicine and Pharmacy Carol Davila; University and Emergency Hospital, Bucharest, Romania
| | - Camillo Felix
- Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Jae-Hyung Kim
- Catholic University of Korea, Department of Medicine, Seoul, South Korea
| | | | - Basil S Lewis
- Lady Davis Carmel Medical Center and the Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Kaj P Metsarinne
- Division of Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Victor Aboyans
- Department of Cardiology, Dupuytren University Hospital & INSERM 1094, Limoges, France
| | - Phillippe Gabriel Steg
- Université de Paris, and Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Masatsugu Hori
- Department of Oncocardiology, Osaka International Cancer Institute, Osaka, Japan
| | - Ajay Kakkar
- Thrombosis Research Institute and University College London, London, UK
| | - Sonia S Anand
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton Canada
| | - Andre Lamy
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton Canada
| | - Mukul Sharma
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton Canada
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton Canada
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Newman JD, Anthopolos R, Mancini GBJ, Bangalore S, Reynolds HR, Kunichoff DF, Senior R, Peteiro J, Bhargava B, Garg P, Escobedo J, Doerr R, Mazurek T, Gonzalez-Juanatey J, Gajos G, Briguori C, Cheng H, Vertes A, Mahajan S, Guzman LA, Keltai M, Maggioni AP, Stone GW, Berger JS, Rosenberg YD, Boden WE, Chaitman BR, Fleg JL, Hochman JS, Maron DJ. Outcomes of Participants With Diabetes in the ISCHEMIA Trials. Circulation 2021; 144:1380-1395. [PMID: 34521217 DOI: 10.1161/circulationaha.121.054439] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Among patients with diabetes and chronic coronary disease, it is unclear if invasive management improves outcomes when added to medical therapy. METHODS The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trials (ie, ISCHEMIA and ISCHEMIA-Chronic Kidney Disease) randomized chronic coronary disease patients to an invasive (medical therapy + angiography and revascularization if feasible) or a conservative approach (medical therapy alone with revascularization if medical therapy failed). Cohorts were combined after no trial-specific effects were observed. Diabetes was defined by history, hemoglobin A1c ≥6.5%, or use of glucose-lowering medication. The primary outcome was all-cause death or myocardial infarction (MI). Heterogeneity of effect of invasive management on death or MI was evaluated using a Bayesian approach to protect against random high or low estimates of treatment effect for patients with versus without diabetes and for diabetes subgroups of clinical (female sex and insulin use) and anatomic features (coronary artery disease severity or left ventricular function). RESULTS Of 5900 participants with complete baseline data, the median age was 64 years (interquartile range, 57-70), 24% were female, and the median estimated glomerular filtration was 80 mL·min-1·1.73-2 (interquartile range, 64-95). Among the 2553 (43%) of participants with diabetes, the median percent hemoglobin A1c was 7% (interquartile range, 7-8), and 30% were insulin-treated. Participants with diabetes had a 49% increased hazard of death or MI (hazard ratio, 1.49 [95% CI, 1.31-1.70]; P<0.001). At median 3.1-year follow-up the adjusted event-free survival was 0.54 (95% bootstrapped CI, 0.48-0.60) and 0.66 (95% bootstrapped CI, 0.61-0.71) for patients with diabetes versus without diabetes, respectively, with a 12% (95% bootstrapped CI, 4%-20%) absolute decrease in event-free survival among participants with diabetes. Female and male patients with insulin-treated diabetes had an adjusted event-free survival of 0.52 (95% bootstrapped CI, 0.42-0.56) and 0.49 (95% bootstrapped CI, 0.42-0.56), respectively. There was no difference in death or MI between strategies for patients with diabetes versus without diabetes, or for clinical (female sex or insulin use) or anatomic features (coronary artery disease severity or left ventricular function) of patients with diabetes. CONCLUSIONS Despite higher risk for death or MI, chronic coronary disease patients with diabetes did not derive incremental benefit from routine invasive management compared with initial medical therapy alone. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01471522.
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Affiliation(s)
- Jonathan D Newman
- New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.)
| | - Rebecca Anthopolos
- New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.)
| | - G B John Mancini
- Center for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada (G.B.J.M.)
| | - Sripal Bangalore
- New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.)
| | - Harmony R Reynolds
- New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.)
| | - Dennis F Kunichoff
- New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.)
| | - Roxy Senior
- Northwick Park Hospital-Royal Brompton Hospital, London, UK (R.S.)
| | - Jesus Peteiro
- Complejo Hospitalario Universitario de A Coruña (CHUAC), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Universidad de A Coruña, A Coruña, Spain (J.P.)
| | | | - Pallav Garg
- London Health Sciences Center, Western University, Ontario, Canada (P.G.)
| | - Jorge Escobedo
- Instituto Mexicano del Seguro Social, Mexico City (J.E.)
| | - Rolf Doerr
- Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.)
| | | | - Jose Gonzalez-Juanatey
- Cardiology Department, Hospital Clínico Universitario, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares Institution, Spain (J.G-J.)
| | - Grzegorz Gajos
- Department of Coronary Disease and Heart Failure, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland (G.G.)
| | - Carlo Briguori
- Laboratory of Interventional Cardiology and Department of Cardiology, Mediterranea Cardiocentro, Naples, Italy (C.B.)
| | - Hong Cheng
- Beijing Anzhen Hospital, Capital Medical University, China (H.C.)
| | - Andras Vertes
- Dél-pesti Centrumkóház Hospital, National Institute of Hematology and Infectious Disease, Cardiovascular Department, Budapest, Hungary (A.V.)
| | | | - Luis A Guzman
- Instituto Médico Docencia Asistencia Médica e Investigación Clínica, Cordoba, Argentina (L.A.G.)
| | | | - Aldo P Maggioni
- Associazione Nazionale Medici Cardiologi Ospedalieri Research Center, Florence, Italy (A.P.M.)
| | - Gregg W Stone
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, Cardiovascular Research Foundation, New York (G.W.S.)
| | - Jeffrey S Berger
- New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.)
| | - Yves D Rosenberg
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (Y.D.R., J.L.F.)
| | - William E Boden
- Veterans Affairs New England Healthcare System, Boston University School of Medicine, MA (W.E.B.)
| | - Bernard R Chaitman
- St Louis University School of Medicine Center for Comprehensive Cardiovascular Care, MO (B.R.C.)
| | - Jerome L Fleg
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (Y.D.R., J.L.F.)
| | | | - David J Maron
- Department of Medicine, Stanford University, CA (D.J.M.)
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5
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Reynolds HR, Shaw LJ, Min JK, Page CB, Berman DS, Chaitman BR, Picard MH, Kwong RY, O'Brien SM, Huang Z, Mark DB, Nath RK, Dwivedi SK, Smanio PEP, Stone PH, Held C, Keltai M, Bangalore S, Newman JD, Spertus JA, Stone GW, Maron DJ, Hochman JS. Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and Ischemia Severity. Circulation 2021; 144:1024-1038. [PMID: 34496632 DOI: 10.1161/circulationaha.120.049755] [Citation(s) in RCA: 124] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The ISCHEMIA trial (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) postulated that patients with stable coronary artery disease (CAD) and moderate or severe ischemia would benefit from revascularization. We investigated the relationship between severity of CAD and ischemia and trial outcomes, overall and by management strategy. METHODS In total, 5179 patients with moderate or severe ischemia were randomized to an initial invasive or conservative management strategy. Blinded, core laboratory-interpreted coronary computed tomographic angiography was used to assess anatomic eligibility for randomization. Extent and severity of CAD were classified with the modified Duke Prognostic Index (n=2475, 48%). Ischemia severity was interpreted by independent core laboratories (nuclear, echocardiography, magnetic resonance imaging, exercise tolerance testing, n=5105, 99%). We compared 4-year event rates across subgroups defined by severity of ischemia and CAD. The primary end point for this analysis was all-cause mortality. Secondary end points were myocardial infarction (MI), cardiovascular death or MI, and the trial primary end point (cardiovascular death, MI, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest). RESULTS Relative to mild/no ischemia, neither moderate ischemia nor severe ischemia was associated with increased mortality (moderate ischemia hazard ratio [HR], 0.89 [95% CI, 0.61-1.30]; severe ischemia HR, 0.83 [95% CI, 0.57-1.21]; P=0.33). Nonfatal MI rates increased with worsening ischemia severity (HR for moderate ischemia, 1.20 [95% CI, 0.86-1.69] versus mild/no ischemia; HR for severe ischemia, 1.37 [95% CI, 0.98-1.91]; P=0.04 for trend, P=NS after adjustment for CAD). Increasing CAD severity was associated with death (HR, 2.72 [95% CI, 1.06-6.98]) and MI (HR, 3.78 [95% CI, 1.63-8.78]) for the most versus least severe CAD subgroup. Ischemia severity did not identify a subgroup with treatment benefit on mortality, MI, the trial primary end point, or cardiovascular death or MI. In the most severe CAD subgroup (n=659), the 4-year rate of cardiovascular death or MI was lower in the invasive strategy group (difference, 6.3% [95% CI, 0.2%-12.4%]), but 4-year all-cause mortality was similar. CONCLUSIONS Ischemia severity was not associated with increased risk after adjustment for CAD severity. More severe CAD was associated with increased risk. Invasive management did not lower all-cause mortality at 4 years in any ischemia or CAD subgroup. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01471522.
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Affiliation(s)
- Harmony R Reynolds
- New York Universty Grossman School of Medicine (H.R.R.., S.B., J.D.N., J.S.H.)
| | - Leslee J Shaw
- Weill Cornell Medicine/New York Presbyterian Hospital (L.J.S.)
| | | | - Courtney B Page
- Duke Clinical Research Institute, Durham, NC (C.B.P., S.M.O., Z.H., D.B.M.)
| | | | - Bernard R Chaitman
- St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, MO (B.R.C.)
| | - Michael H Picard
- Massachusetts General Hospital and Harvard Medical School, Boston (M.H.P.)
| | | | - Sean M O'Brien
- Duke Clinical Research Institute, Durham, NC (C.B.P., S.M.O., Z.H., D.B.M.)
| | - Zhen Huang
- Duke Clinical Research Institute, Durham, NC (C.B.P., S.M.O., Z.H., D.B.M.)
| | - Daniel B Mark
- Duke Clinical Research Institute, Durham, NC (C.B.P., S.M.O., Z.H., D.B.M.)
| | - Ranjit K Nath
- Dr. Ram Manohar Lohia Hospital, New Delhi, India (R.K.N.)
| | | | - Paola E P Smanio
- Instituto Dante Pazzanese de Cardiologia e Fleury Medicina e Saúde, São Paulo, Brazil (P.E.P.S.)
| | - Peter H Stone
- Brigham and Women's Hospital, Boston, MA (R.Y.K., P.H.S.)
| | - Claes Held
- Department of Medical Sciences, Cardiology, Uppsala University and Uppsala Clinical Research Center, Sweden (C.H.)
| | | | - Sripal Bangalore
- New York Universty Grossman School of Medicine (H.R.R.., S.B., J.D.N., J.S.H.)
| | - Jonathan D Newman
- New York Universty Grossman School of Medicine (H.R.R.., S.B., J.D.N., J.S.H.)
| | - John A Spertus
- Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.)
| | - Gregg W Stone
- Icahn School of Medicine at Mount Sinai, Cardiovascular Research Foundation, New York (G.W.S.)
| | - David J Maron
- Department of Medicine, Stanford University, CA (D.J.M.)
| | - Judith S Hochman
- New York Universty Grossman School of Medicine (H.R.R.., S.B., J.D.N., J.S.H.)
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6
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Lopez-Sendon JL, Cyr DD, Mark DB, Bangalore S, Huang Z, White HD, Alexander KP, Li J, Nair RG, Demkow M, Peteiro J, Wander GS, Demchenko EA, Gamma R, Gadkari M, Poh KK, Nageh T, Stone PH, Keltai M, Sidhu M, Newman JD, Boden WE, Reynolds HR, Chaitman BR, Hochman JS, Maron DJ, O'Brien SM. Effects of initial invasive vs. initial conservative treatment strategies on recurrent and total cardiovascular events in the ISCHEMIA trial. Eur Heart J 2021; 43:148-149. [PMID: 34514494 DOI: 10.1093/eurheartj/ehab509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/26/2021] [Accepted: 08/16/2021] [Indexed: 12/24/2022] Open
Abstract
AIMS The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial prespecified an analysis to determine whether accounting for recurrent cardiovascular events in addition to first events modified understanding of the treatment effects. METHODS AND RESULTS Patients with stable coronary artery disease (CAD) and moderate or severe ischaemia on stress testing were randomized to either initial invasive (INV) or initial conservative (CON) management. The primary outcome was a composite of cardiovascular death, myocardial infarction (MI), and hospitalization for unstable angina, heart failure, or cardiac arrest. The Ghosh-Lin method was used to estimate mean cumulative incidence of total events with death as a competing risk. The 5179 ISCHEMIA patients experienced 670 index events (318 INV, 352 CON) and 203 recurrent events (102 INV, 101 CON). A single primary event was observed in 9.8% of INV and 10.8% of CON patients while ≥2 primary events were observed in 2.5% and 2.8%, respectively. Patients with recurrent events were older; had more frequent hypertension, diabetes, prior MI, or cerebrovascular disease; and had more multivessel CAD. The average number of primary endpoint events per 100 patients over 4 years was 18.2 in INV [95% confidence interval (CI) 15.8-20.9] and 19.7 in CON (95% CI 17.5-22.2), difference -1.5 (95% CI -5.0 to 2.0, P = 0.398). Comparable results were obtained when all-cause death was substituted for cardiovascular death and when stroke was added as an event. CONCLUSIONS In stable CAD patients with moderate or severe myocardial ischaemia enrolled in ISCHEMIA, an initial INV treatment strategy did not prevent either net recurrent events or net total events more effectively than an initial CON strategy. CLINICAL TRIAL REGISTRATION ISCHEMIA ClinicalTrials.gov number, NCT01471522, https://clinicaltrials.gov/ct2/show/NCT01471522.
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Affiliation(s)
- Jose L Lopez-Sendon
- Cardiology department, Hospital Universitario La Paz, Idipaz, UAM, CIBER-CV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Derek D Cyr
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
| | - Daniel B Mark
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
| | - Sripal Bangalore
- NYU Grossman School of Medicine, 530 First Avenue, New York, NY, USA
| | - Zhen Huang
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
| | - Harvey D White
- Auckland City Hospital Green Lane Cardiovascular Services and University of Auckland, 2 Park Road, Grafton, Auckland 1023, New Zealand
| | - Karen P Alexander
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
| | - Jianghao Li
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
| | - Rajesh Goplan Nair
- Government Medical College, 48/584, Subhag Sastrinagar, Thiruvananthapuram, Kerala 695002, India
| | - Marcin Demkow
- Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Alpejska 42, Warsaw 04-628, Poland
| | - Jesus Peteiro
- CHUAC, Universidad de A Coruña, CIBER-CV, As Xubias, 84, A Coruna 15006, Spain
| | - Gurpreet S Wander
- Dayanand Medical College & Hospital, Civil Lines, Tagore Nagar, Ludhiana, Punjab 141001, India
| | - Elena A Demchenko
- Almazov National Medical Research Centre, Ulitsa Akkuratova, 2, Saint-Petersburg 197341, Russia
| | - Reto Gamma
- Broomfield Hospital, Court Rd, Broomfield, Chelmsford CM1 7ET, UK
| | - Milind Gadkari
- Kem Hospital Maharashtra, 489, Mudaliar Rd, Rasta Peth, Pune, Maharashtra 411011, India
| | - Kian Keong Poh
- National University Heart Center Singapore, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
| | - Thuraia Nageh
- Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Southend-on-Sea, Westcliff-on-Sea SS0 0RY, Southend, England, UK
| | - Peter H Stone
- Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Matyas Keltai
- Semmelweis University, Budapest, Üllői út 26, 1085 Hungary
| | - Mandeep Sidhu
- Albany Medical College, 47 New Scotland Avenue, Physicians Pavilion, 2nd Floor, Albany, NY 12208, USA
| | - Jonathan D Newman
- NYU Grossman School of Medicine, 530 First Avenue, New York, NY, USA
| | - William E Boden
- VA New England Healthcare System, Boston University School of Medicine, 150 South Huntington Avenue, Boston, MA, USA
| | | | - Bernard R Chaitman
- St Louis University School of Medicine Center for Comprehensive Cardiovascular Care, 1034 S. Brentwood Blvd., Suite 1120, St. Louis, MO, USA
| | - Judith S Hochman
- NYU Grossman School of Medicine, 530 First Avenue, New York, NY, USA
| | - David J Maron
- Department of Medicine, Stanford University, 300 Pasteur Drive, Falk CVRC 265, Stanford, CA 94305-5406, USA
| | - Sean M O'Brien
- Duke Clinical Research Institute and Duke University, 300 W. Morgan Street, Durham, NC, USA
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7
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Bajaj HS, Gerstein HC, Rao-Melacini P, Basile J, Colhoun H, Conget I, Cushman WC, Dagenais GR, Franek E, Hanefeld M, Keltai M, Lakshmanan M, Lanas F, Leiter LA, Lopez-Jaramillo P, Pirags V, Pogosova N, Probstfield J, Raubenheimer P, Ryden L, Shaw JE, Sheu WHH, Xavier D. Erectile function in men with type 2 diabetes treated with dulaglutide: an exploratory analysis of the REWIND placebo-controlled randomised trial. Lancet Diabetes Endocrinol 2021; 9:484-490. [PMID: 34153269 DOI: 10.1016/s2213-8587(21)00115-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Diabetes is a major risk factor for erectile dysfunction, however, the effect of GLP-1 receptor agonists on erectile dysfunction is unknown. We aimed to assess the incidence, prevalence, and progression of erectile dysfunction in men treated with dulaglutide compared with placebo, and to determine whether dulaglutide's effect on erectile dysfunction was consistent with its effect on other diabetes-related outcomes. METHODS The Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) trial was a double-blind, placebo-controlled randomised trial of the effect of dulaglutide on cardiovascular outcomes. REWIND was done at 371 sites in 24 countries. Men and women aged older than 50 years with type 2 diabetes, who had either a previous cardiovascular event or cardiovascular risk factors, were randomly assigned (1:1) to receive either dulaglutide or placebo. Participating men were offered the opportunity to complete the standardised International Index of Erectile Function (IIEF) questionnaire at baseline, 2 years, 5 years, and study end. We did an exploratory analysis, in which we included participants who completed a baseline and at least 1 follow-up IIEF questionnaire. The primary outcome for these analyses was the first occurrence of moderate or severe erectile dysfunction following randomisation, assessed by the erectile function subscores on IIEF. This analysis was part of the REWIND trial, which is registered with ClinicalTrials.gov, NCT01394952. FINDINGS Between Aug 18, 2011, and Aug 14, 2013, 3725 (70·1%) of 5312 male participants with a mean age of 65·5 years (SD 6·4 years) were analysed, of whom 1487 (39·9%) had a history of cardiovascular disease, and 2104 (56·5%) had moderate or severe erectile dysfunction at baseline. The incidence of erectile dysfunction following randomisation was 21·3 per 100 person-years in the dulaglutide group and 22·0 per 100 person-years in the placebo group (HR 0·92, 95% CI 0·85-0·99, p=0·021). Men in the dulaglutide group also had a lesser fall in erectile function subscore compared with the placebo group, with a least square mean difference of 0·61 (95% CI 0·18-1·05, p=0·006). INTERPRETATION Long-term use of dulaglutide might reduce the incidence of moderate or severe erectile dysfunction in men with type 2 diabetes. FUNDING Eli Lilly and Company.
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Affiliation(s)
| | - Hertzel C Gerstein
- Population Health Research Institute, McMaster University Medical Centre-Hamilton Health Sciences, Hamilton, ON, Canada.
| | - Purnima Rao-Melacini
- Population Health Research Institute, McMaster University Medical Centre-Hamilton Health Sciences, Hamilton, ON, Canada
| | - Jan Basile
- Ralph H Johnson VA Medical Center, Medical University of South Carolina, Charleston, SC, USA
| | - Helen Colhoun
- Medical Informatics and Epidemiology, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Ignacio Conget
- Endocrinology and Nutrition Department, University of Barcelona, Barcelona, Spain
| | - William C Cushman
- Preventive Medicine and Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Gilles R Dagenais
- Clinical Research Center, Laval University, Quebec Heart and Lung Institute, Quebec City, QC, Canada
| | - Edward Franek
- Mossakowski Clinical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Markolf Hanefeld
- Department of Internal Medicine, Dresden Technical University, Dresden, Germany
| | - Matyas Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary
| | | | - Fernando Lanas
- Department of Internal Medicine, Universidad de La Fontera, Temuco, Chile
| | - Lawrence A Leiter
- Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | | | - Valdis Pirags
- Department of Internal Medicine, University of Latvia, Riga, Latvia
| | - Nana Pogosova
- National Medical Research Center of Cardiology, Moscow, Russia
| | | | - Peter Raubenheimer
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Lars Ryden
- Department of Medicine, Karolinska University, Solna, Sweden
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Wayne H-H Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Denis Xavier
- St John's Medical College, St John's National Academy of Health Sciences, Bangalore, India
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8
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Bosch J, Lonn EM, Jung H, Zhu J, Liu L, Lopez-Jaramillo P, Pais P, Xavier D, Diaz R, Dagenais G, Dans A, Avezum A, Piegas LS, Parkhomenko A, Keltai K, Keltai M, Sliwa K, Held C, Peters RJG, Lewis BS, Jansky P, Yusoff K, Khunti K, Toff WD, Reid CM, Varigos J, Joseph P, Leiter LA, Yusuf S. Lowering cholesterol, blood pressure, or both to prevent cardiovascular events: results of 8.7 years of follow-up of Heart Outcomes Evaluation Prevention (HOPE)-3 study participants. Eur Heart J 2021; 42:2995-3007. [PMID: 33963372 PMCID: PMC8370761 DOI: 10.1093/eurheartj/ehab225] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/26/2020] [Accepted: 04/10/2021] [Indexed: 01/21/2023] Open
Abstract
Aims Rosuvastatin (10 mg per day) compared with placebo reduced major adverse cardiovascular (CV) events by 24% in 12 705 participants at intermediate CV risk after 5.6 years. There was no benefit of blood pressure (BP) lowering treatment in the overall group, but a reduction in events in the third of participants with elevated systolic BP. After cessation of all the trial medications, we examined whether the benefits observed during the active treatment phase were sustained, enhanced, or attenuated. Methods and results After the randomized treatment period (5.6 years), participants were invited to participate in 3.1 further years of observation (total 8.7 years). The first co-primary outcome for the entire length of follow-up was the composite of myocardial infarction, stroke, or CV death [major adverse cardiovascular event (MACE)-1], and the second was MACE-1 plus resuscitated cardiac arrest, heart failure, or coronary revascularization (MACE-2). In total, 9326 (78%) of 11 994 surviving Heart Outcomes Prevention Evaluation (HOPE)-3 subjects consented to participate in extended follow-up. During 3.1 years of post-trial observation (total follow-up of 8.7 years), participants originally randomized to rosuvastatin compared with placebo had a 20% additional reduction in MACE-1 [95% confidence interval (CI), 0.64–0.99] and a 17% additional reduction in MACE-2 (95% CI 0.68–1.01). Therefore, over the 8.7 years of follow-up, there was a 21% reduction in MACE-1 (95% CI 0.69–0.90, P = 0.005) and 21% reduction in MACE-2 (95% CI 0.69–0.89, P = 0.002). There was no benefit of BP lowering in the overall study either during the active or post-trial observation period, however, a 24% reduction in MACE-1 was observed over 8.7 years. Conclusion The CV benefits of rosuvastatin, and BP lowering in those with elevated systolic BP, compared with placebo continue to accrue for at least 3 years after cessation of randomized treatment in individuals without cardiovascular disease indicating a legacy effect. Trial Registration Number NCT00468923
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Affiliation(s)
- Jackie Bosch
- The Population Health Research Institute, Hamilton Health Sciences, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.,The School of Rehabilitation Science, McMaster University, IAHS, Room 403, 1400 Main St. West, Hamilton, ON L8S 1C7, Canada
| | - Eva M Lonn
- The Population Health Research Institute, Hamilton Health Sciences, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.,The Department of Medicine, 1200 Main St. West, McMaster University, Hamilton, ON L8N 3Z5, Canada
| | - Hyejung Jung
- The Population Health Research Institute, Hamilton Health Sciences, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada
| | - Jun Zhu
- Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 Dongdan 3rd Alley, Dong Dan, Dongcheng, Beijing
| | - Lisheng Liu
- Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 Dongdan 3rd Alley, Dong Dan, Dongcheng, Beijing
| | - Patricio Lopez-Jaramillo
- Instituto Masira, Facultad de Salud, Universidad de Santander, Calle 70 No 55-210, Bucaramanga, Colombia
| | - Prem Pais
- St. John's Research Institute, 100 Feet Rd, John Nagar, Koramangala, Bangalore, Karnataka 560034, India
| | - Denis Xavier
- St. John's Research Institute, 100 Feet Rd, John Nagar, Koramangala, Bangalore, Karnataka 560034, India.,St. John's Medical College, Sarjarpur Road, Bangalore, Karnataka 560034, India
| | - Rafael Diaz
- Instituto Cardiovascular de Rosario, DSR, Bv. Oroño 440, S2000 Rosario, Santa Fe, Argentina
| | - Gilles Dagenais
- Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, 2725 Ch Ste-Foy, Québec, QC G1V 4G5, Canada
| | - Antonio Dans
- College of Medicine, University of the Philippines, Pedro Gil Street, Taft Ave, Ermita, Manila, 1000 Metro Manila, Philippines
| | - Alvaro Avezum
- Dante Pazzanese Institute of Cardiology and Sao Paulo University, Av. Dr. Dante Pazzanese, 500 - Vila Mariana, São Paulo - SP, 04012-909, Brazil
| | - Leopoldo S Piegas
- HCor-Hospital do Coração, Des. Eliseu Guilherme, 147 - Paraíso, São Paulo - SP, 04004-030, Brazil
| | | | - Kati Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary
| | - Matyas Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary
| | - Karen Sliwa
- Department of Medicine, Hatter Institute for Cardiovascular Research, University of Cape Town, Soweto Cardiovascular Research Group, 4th, 5th and 6th Floor, Chris Barnard Building Faculty of Health Sciences, Private Bag X3 7935, Cape Town, South Africa
| | - Claus Held
- The Uppsala Clinical Research Centre and Institute for Medical Sciences, Cardiology, Uppsala University, Uppsala Academic Hospital, Dag Hammarskjölds Väg 21, 752 37 Uppsala, Sweden
| | - Ronald J G Peters
- The Department of Cardiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - Basil S Lewis
- Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Efron St 1, Haifa, Israel
| | - Petr Jansky
- University Hospital Motol, V Úvalu 84, 150 06 Praha 5, Czechia
| | - Khalid Yusoff
- Universiti Teknologi Majlis Amansh Rakyat, Jalan Ilmu 1/1, 40450 Shah Alam, Selangor, Malaysia.,University College Sedaya International University, UCSI Heights, 1, Jalan Puncak Menara Gading, Taman Connaught, 56000 Cheras, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Kamlesh Khunti
- Leicester Diabetes Centre, Gwendolen Rd, Leicester LE5 4PW, UK
| | - William D Toff
- Department of Cardiovascular Sciences, University of Leicester, University Rd, Leicester LE1 7RH, UK.,UK and National Institute for Health Research, Leicester Biomedical Research Centre, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd., Melbourne, VIC 3004, Australia.,The School of Public Health, Curtin University, Kent St, Bentley Perth, WA 6102, Australia
| | - John Varigos
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd., Melbourne, VIC 3004, Australia
| | - Philip Joseph
- The Population Health Research Institute, Hamilton Health Sciences, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.,The School of Rehabilitation Science, McMaster University, IAHS, Room 403, 1400 Main St. West, Hamilton, ON L8S 1C7, Canada
| | - Lawrence A Leiter
- Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, 209 Victoria St, Toronto, ON M5B 1T8, Canada
| | - Salim Yusuf
- The Population Health Research Institute, Hamilton Health Sciences, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.,The School of Rehabilitation Science, McMaster University, IAHS, Room 403, 1400 Main St. West, Hamilton, ON L8S 1C7, Canada
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9
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Newman J, Anthopolos R, Mancini GJ, Bangalore S, Reynolds H, Senior R, Peteiro J, Bhargava B, Garg P, Escobedo J, Doerr R, Mazurek T, Oomman A, Gonzalez-Juanatey J, Gajos G, Sharir T, Keltai M, Maggioni AP, Stone G, Berger J, Rosenberg Y, Boden W, Chaitman B, Hochman J, Maron D. MANAGEMENT AND OUTCOMES OF PATIENTS WITH DIABETES MELLITUS (DM) AND STABLE ISCHEMIC HEART DISEASE (SIHD): POOLED DATA FROM THE ISCHEMIA AND ISCHEMIA-CKD TRIALS. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01497-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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10
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De Caterina R, Patti G, Westerbergh J, Horowitz J, Ezekowitz JA, Lewis BS, Lopes RD, McMurray JJV, Atar D, Bahit MC, Keltai M, López-Sendón JL, Ruzyllo W, Granger CB, Alexander JH, Wallentin L. Heterogeneity of diabetes as a risk factor for major adverse cardiovascular events in anticoagulated patients with atrial fibrillation: an analysis of the ARISTOTLE trial. Eur Heart J Cardiovasc Pharmacother 2020; 8:227-235. [PMID: 33367487 DOI: 10.1093/ehjcvp/pvaa140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/14/2020] [Accepted: 12/07/2020] [Indexed: 12/11/2022]
Abstract
AIMS Whether diabetes without insulin therapy is an independent cardiovascular (CV) risk factor in atrial fibrillation (AF) has recently been questioned. We investigated the prognostic relevance of diabetes with or without insulin treatment in patients in the ARISTOTLE trial. METHODS AND RESULTS Patients with AF and increased stroke risk randomized to apixaban vs. warfarin were classified according to diabetes status: no diabetes; diabetes on no diabetes medications; diabetes on non-insulin antidiabetic drugs only; or insulin-treated. The associations between such patient subgroups and stroke/systemic embolism (SE), myocardial infarction (MI), and CV death were examined by Cox proportional hazard regression, both unadjusted and adjusted for other prognostic variables. Patients with diabetes were younger and had a higher body mass index. Median CHA2DS2VASc score was 4.0 in patients with diabetes and 3.0 in patients without diabetes. We found no significant difference in stroke/SE incidence across patient subgroups. Compared with no diabetes, only insulin-treated diabetes was significantly associated with higher risk. When adjusted for clinical variables, compared with no diabetes, the hazard ratios (HRs) for MI (95% confidence intervals) were for diabetes on no medication: 1.15 (0.62-2.14); for diabetes on non-insulin antidiabetic drugs: 1.32 (0.90-1.94); for insulin-treated diabetes: 2.34 (1.43-3.82); interaction P = 0.008. HRs for CV death were for diabetes on no medication: 1.19 (0.86-166); for diabetes on non-insulin antidiabetic drugs: 1.12 (0.88-1.42); for insulin-treated diabetes 1.85 (1.36-2.53), interaction P = 0.001. CONCLUSION In anticoagulated patients with AF, a higher risk of MI and CV death is largely confined to diabetes treated with insulin.
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Affiliation(s)
- Raffaele De Caterina
- Chair of Cardiology, University of Pisa, and Cardiovascular Division, Pisa University Hospital, Via Paradisa 2, 56126 Pisa, Italy.,Fondazione Villa Serena per la Ricerca, Città Sant'Angelo, Italy
| | | | - Johan Westerbergh
- Uppsala Clinical Research Center, Uppsala University, Dag Hammarskjölds väg 38, 751 85 Uppsala, Sweden
| | | | | | | | - Renato D Lopes
- Duke Clinical Research Institute, Duke Medicine, Durham, NC, USA
| | - John J V McMurray
- BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Dan Atar
- Department of Cardiology, Oslo University Hospital Ulleval and Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - M Cecilia Bahit
- INECO Neurociencias Oroño, Fundación INECO, Rosario, Argentina
| | - Matyas Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary
| | | | | | | | - John H Alexander
- Duke Clinical Research Institute, Duke Medicine, Durham, NC, USA
| | - Lars Wallentin
- Uppsala Clinical Research Center, Uppsala University, Dag Hammarskjölds väg 38, 751 85 Uppsala, Sweden.,Department of Medical Sciences, Cardiology, Uppsala University, Uppsala University Hospital ingång 40, 751 85 Uppsala, Sweden
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11
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Sharma M, Hart RG, Smith EE, Bosch J, Eikelboom JW, Connolly SJ, Dyal L, Reeh KW, Casanova A, Diaz R, Lopez-Jaramillo P, Ertl G, Störk S, Dagenais GR, Lonn EM, Ryden L, Tonkin AM, Varigos JD, Bhatt DL, Branch KR, Probstfield JL, Kim JH, O’Donnell M, Vinereanu D, A.A. Fox K, Liang Y, Liu L, Zhu J, Pogosova N, Maggioni AP, Avezum A, Piegas LS, Keltai K, Keltai M, Berkowitz SD, Yusuf S. Rivaroxaban for Prevention of Covert Brain Infarcts and Cognitive Decline. Stroke 2020; 51:2901-2909. [DOI: 10.1161/strokeaha.120.029762] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background and Purpose:
Covert brain infarcts are associated with cognitive decline. It is not known whether therapies that prevent symptomatic stroke prevent covert infarcts. COMPASS compared rivaroxaban with and without aspirin with aspirin for the prevention of stroke, myocardial infarction, and vascular death in participants with stable vascular disease and was terminated early because of benefits of rivaroxaban 2.5 mg twice daily plus aspirin over aspirin. We obtained serial magnetic resonance imagings and cognitive tests in a consenting subgroup of COMPASS patients to examine treatment effects on infarcts, cerebral microbleeds, and white matter hyperintensities.
Methods:
Baseline and follow-up magnetic resonance imagings were completed in 1445 participants with a mean (SD) interval of 2.0 (0.7) years. Whole-brain T1, T2 fluid-attenuated inversion recovery, T2* sequences were centrally interpreted by blinded, trained readers. Participants had serial measurements of cognition and function. The primary end point was the proportion of participants with incident covert infarcts. Secondary end points were the composite of clinical stroke and covert brain infarcts, cerebral microbleeds, and white matter hyperintensities.
Results:
At baseline, 493 (34.1%) participants had infarcts. Incident covert infarcts occurred in 55 (3.8%) participants. In the overall trial rivaroxaban plus aspirin reduced ischemic stroke by 49% (0.7% versus 1.4%; hazard ratio [95% CI], 0.51 [0.38–0.68]). In the magnetic resonance imaging substudy the effects of rivaroxaban+aspirin versus aspirin were: covert infarcts: 2.7% versus 3.5% (odds ratio [95% CI], 0.77 [0.37–1.60]); Covert infarcts or ischemic stroke: 2.9% versus 5.3% (odds ratio [95% CI], 0.53 [0.27–1.03]). Incident microbleeds occurred in 6.6% of participants and 65.7% of participants had an increase in white matter hyperintensities volume with no effect of treatment for either end point. There was no effect on cognitive tests.
Conclusions:
Covert infarcts were not significantly reduced by treatment with rivaroxaban and aspirin but estimates for the combination of ischemic stroke and covert infarcts were consistent with the effect on ischemic stroke in the overall trial.
Registration:
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01776424.
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Affiliation(s)
- Mukul Sharma
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (M.S., R.G.H., J.B., J.W.E., S.J.C., L.D., K.W.R., A.C., E.M.L., S.Y.)
| | - Robert G. Hart
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (M.S., R.G.H., J.B., J.W.E., S.J.C., L.D., K.W.R., A.C., E.M.L., S.Y.)
| | - Eric E. Smith
- Hotchkiss Brain Institute, University of Calgary, AB, Canada (E.E.S.)
| | - Jacqueline Bosch
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (M.S., R.G.H., J.B., J.W.E., S.J.C., L.D., K.W.R., A.C., E.M.L., S.Y.)
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada (J.B.)
| | - John W. Eikelboom
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (M.S., R.G.H., J.B., J.W.E., S.J.C., L.D., K.W.R., A.C., E.M.L., S.Y.)
| | - Stuart J. Connolly
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (M.S., R.G.H., J.B., J.W.E., S.J.C., L.D., K.W.R., A.C., E.M.L., S.Y.)
| | - Leanne Dyal
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (M.S., R.G.H., J.B., J.W.E., S.J.C., L.D., K.W.R., A.C., E.M.L., S.Y.)
| | - Kevin W Reeh
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (M.S., R.G.H., J.B., J.W.E., S.J.C., L.D., K.W.R., A.C., E.M.L., S.Y.)
| | - Amparo Casanova
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (M.S., R.G.H., J.B., J.W.E., S.J.C., L.D., K.W.R., A.C., E.M.L., S.Y.)
| | - Rafael Diaz
- Estudios Clinicos Latino America and Instituto Cardiovascular de Rosario, Argentina (R.D.)
| | | | - Georg Ertl
- Comprehensive Heart Failure Center, University and University Hospital, Würzburg, Germany (G.E., S.S.)
| | - Stefan Störk
- Comprehensive Heart Failure Center, University and University Hospital, Würzburg, Germany (G.E., S.S.)
| | - Gilles R. Dagenais
- Institut Universitaire de Cardiologie et Pneumologie de Quebec, Quebec City, Canada (G.R.D.)
| | - Eva M. Lonn
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (M.S., R.G.H., J.B., J.W.E., S.J.C., L.D., K.W.R., A.C., E.M.L., S.Y.)
| | - Lars Ryden
- Karolinska Institutet, Stockholm, Sweden (L.R.)
| | | | | | - Deepak L. Bhatt
- Brigham and Women’s Hospital Heart and Vascular Center, Harvard, Medical School, Boston, MA (D.L.B.)
| | - Kelley R.H. Branch
- University of Washington Medical Centre, Seattle (K.R.H.B.)
- University of Washington, Seattle (K.R.H.B., J.L.P.)
| | | | - Jae-Hyung Kim
- The Catholic University of Korea, Seoul, Korea (J.-H.K.)
| | | | - Dragos Vinereanu
- University of Medicine and Pharmacology Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.)
| | - Keith A.A. Fox
- Centre for Cardiovascular Science, University of Edinburgh, Scotland, United Kingdom (K.A.A.F.)
| | - Yan Liang
- FuWai Hospital, Beijing, China (Y.L., L.L., J.Z.)
| | - Lisheng Liu
- FuWai Hospital, Beijing, China (Y.L., L.L., J.Z.)
| | - Jun Zhu
- FuWai Hospital, Beijing, China (Y.L., L.L., J.Z.)
| | - Nana Pogosova
- National Medical Research Center of Cardiology, Moscow, Russia (N.P.)
| | | | - Alvaro Avezum
- Hospital Alemão Oswaldo Cruz, Sao Paulo, Brazil (A.A.)
| | | | | | - Matyas Keltai
- Semmelweis University, Budapest, Hungary (K.K., M.K.)
| | | | - Salim Yusuf
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (M.S., R.G.H., J.B., J.W.E., S.J.C., L.D., K.W.R., A.C., E.M.L., S.Y.)
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12
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Hijazi Z, Granger CB, Hohnloser SH, Westerbergh J, Lindbäck J, Alexander JH, Keltai M, Parkhomenko A, López-Sendón JL, Lopes RD, Siegbahn A, Wallentin L. Association of Different Estimates of Renal Function With Cardiovascular Mortality and Bleeding in Atrial Fibrillation. J Am Heart Assoc 2020; 9:e017155. [PMID: 32865097 PMCID: PMC7726979 DOI: 10.1161/jaha.120.017155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background We compared different methods of estimated glomerular filtration rate (eGFR) and their association with cardiovascular death and major bleeding in 14 980 patients with atrial fibrillation in the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial. Methods and Results eGFR was calculated using equations based on creatinine (Cockcroft‐Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration [CKD‐EPI]) and/or cystatin C (CKD‐EPICysC and CKD‐EPICysC+Creatinine). These 5 eGFR equations, as well as the individual variables that are used in these equations, were assessed for correlation and discriminatory ability for cardiovascular death and major bleeding. The median age was 70.0 years, and 35.6% were women. The median eGFR was highest with Cockcroft‐Gault (74.1 mL/min) and CKD‐EPICysC (74.2 mL/min), and lowest with Modification of Diet in Renal Disease (66.5 mL/min). Correlation between methods ranged from 0.49 (Cockroft‐Gault and CKD‐EPICysC) to 0.99 (Modification of Diet in Renal Disease and CKD‐EPI). Among the eGFR equations, those based on cystatin C yielded the highest C indices for cardiovascular death and major bleeding: 0.628 (CKD‐EPICysC) and 0.612 (CKD‐EPICysC+Creatinine), respectively. A model based on the variables within the different eGFR equations (age, sex, weight, creatinine, and cystatin C) yielded the highest discriminatory value for both outcomes, with a C index of 0.673 and 0.656, respectively. Conclusions In patients with atrial fibrillation on anticoagulation, correlation between eGFR calculated using different methods varied substantially. Cystatin C–based eGFRs seem to provide the most robust information for predicting death and bleeding. A model based on the individual variables within the eGFR equations, however, provided the highest discriminatory value. Our findings may help refine risk stratification in patients with atrial fibrillation and define how renal function should be determined in future atrial fibrillation studies. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00412984.
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Affiliation(s)
- Ziad Hijazi
- Department of Medical Sciences Cardiology Uppsala University Uppsala Sweden.,Uppsala Clinical Research Center Uppsala University Uppsala Sweden
| | | | | | | | - Johan Lindbäck
- Uppsala Clinical Research Center Uppsala University Uppsala Sweden
| | - John H Alexander
- Duke Clinical Research Institute Duke University School of Medicine Durham NC
| | - Matyas Keltai
- Hungarian Institute of Cardiology Semmelweis University Budapest Hungary
| | | | | | - Renato D Lopes
- Duke Clinical Research Institute Duke University School of Medicine Durham NC
| | - Agneta Siegbahn
- Uppsala Clinical Research Center Uppsala University Uppsala Sweden.,Department of Medical Sciences Clinical Chemistry Uppsala University Uppsala Sweden
| | - Lars Wallentin
- Department of Medical Sciences Cardiology Uppsala University Uppsala Sweden.,Uppsala Clinical Research Center Uppsala University Uppsala Sweden
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13
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Cukierman-Yaffe T, Gerstein HC, Colhoun HM, Diaz R, García-Pérez LE, Lakshmanan M, Bethel A, Xavier D, Probstfield J, Riddle MC, Rydén L, Atisso CM, Hall S, Rao-Melacini P, Basile J, Cushman WC, Franek E, Keltai M, Lanas F, Leiter LA, Lopez-Jaramillo P, Pirags V, Pogosova N, Raubenheimer PJ, Shaw JE, Sheu WHH, Temelkova-Kurktschiev T. Effect of dulaglutide on cognitive impairment in type 2 diabetes: an exploratory analysis of the REWIND trial. Lancet Neurol 2020; 19:582-590. [PMID: 32562683 DOI: 10.1016/s1474-4422(20)30173-3] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/10/2020] [Accepted: 04/23/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Diabetes is an independent risk factor for cognitive impairment. We aimed to investigate the association between the glucagon-like peptide-1 (GLP-1) receptor agonist dulaglutide and cognitive impairment as an exploratory analysis within the Researching Cardiovascular Events With a Weekly Incretin in Diabetes (REWIND) trial. METHODS REWIND is a randomised, double-blind placebo-controlled trial at 371 sites in 24 countries. We included men and women (aged ≥50 years) with either established or newly diagnosed type 2 diabetes and additional cardiovascular risk factors, glycated haemoglobin of up to 9·5% (80 mmol/mol) on a maximum of two oral glucose-lowering drugs with or without basal insulin, and a body-mass index of at least 23 kg/m2. Participants were randomly assigned (1:1) subcutaneous injections once a week of either dulaglutide (1·5 mg) or an equal volume of matching placebo. Randomisation was done using a computer-generated code with stratification by site. Participants and all study personnel were masked to treatment allocation until the database was locked. Participants were followed up at least every 6 months for the composite primary outcome of stroke, myocardial infarction, or death from cardiovascular or unknown causes. Cognitive function was assessed at baseline and during follow-up using the Montreal Cognitive Assessment (MoCA) and Digit Symbol Substitution Test (DSST). We present here the exploratory primary cognitive outcome, which was the first occurrence of a follow-up score on MoCA or DSST that was 1·5 SDs or more below the baseline mean score in the participant's country. All analyses were done using an intention-to-treat approach. The REWIND trial is registered with ClinicalTrials.gov, NCT01394952. FINDINGS Between Aug 18, 2011, and Aug 14, 2013, 9901 participants were randomly assigned to either dulaglutide (n=4949) or placebo (n=4952). During median follow-up of 5·4 (IQR 5·1-5·9) years, 8828 participants provided a baseline and one or more follow-up MoCA or DSST scores, of whom 4456 were assigned dulaglutide and 4372 were assigned placebo. The cognitive outcome occurred in 4·05 per 100 patient-years in participants assigned dulaglutide and 4·35 per 100 patient-years in people assigned placebo (hazard ratio [HR] 0·93, 95% CI 0·85-1·02; p=0·11). After post-hoc adjustment for individual standardised baseline scores, the hazard of substantive cognitive impairment was reduced by 14% in those assigned dulaglutide (HR 0·86, 95% CI 0·79-0·95; p=0·0018). INTERPRETATION Long-term treatment with dulaglutide might reduce cognitive impairment in people with type 2 diabetes. Further studies of this drug focused on brain health and cognitive function are clearly indicated. FUNDING Eli Lilly and Company.
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Affiliation(s)
- Tali Cukierman-Yaffe
- Endocrinology Institute, Gertner Institute, Sheba Medical Center, Ramat-Gan, Israel; Epidemiology Department, Sackler School of Medicine, Herceg Institute of Aging, Tel Aviv University, Tel Aviv, Israel
| | - Hertzel C Gerstein
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
| | | | - Rafael Diaz
- Estudios Clínicos Latino América, Rosario, Argentina
| | | | | | | | | | | | - Matthew C Riddle
- Department of Medicine, Oregon Health and Science University Portland, OR, USA
| | - Lars Rydén
- Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden
| | | | - Stephanie Hall
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Purnima Rao-Melacini
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Jan Basile
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Edward Franek
- Mossakowski Medical Research Centre, Polish Academy of Sciences and Central Clinical Hospital, Warsaw, Poland
| | - Matyas Keltai
- Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary
| | | | - Lawrence A Leiter
- Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | | | | | - Nana Pogosova
- National Medical Research Center of Cardiology, Moscow, Russia
| | | | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Wayne H-H Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
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14
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Franchi F, James SK, Ghukasyan Lakic T, Budaj AJ, Cornel JH, Katus HA, Keltai M, Kontny F, Lewis BS, Storey RF, Himmelmann A, Wallentin L, Angiolillo DJ. Impact of Diabetes Mellitus and Chronic Kidney Disease on Cardiovascular Outcomes and Platelet P2Y 12 Receptor Antagonist Effects in Patients With Acute Coronary Syndromes: Insights From the PLATO Trial. J Am Heart Assoc 2020; 8:e011139. [PMID: 30857464 PMCID: PMC6475041 DOI: 10.1161/jaha.118.011139] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background There are limited data on how the combination of diabetes mellitus (DM) and chronic kidney disease (CKD) affects cardiovascular outcomes as well as response to different P2Y12 receptor antagonists, which represented the aim of the present investigation. Methods and Results In this post hoc analysis of the PLATO (Platelet Inhibition and Patient Outcomes) trial, which randomized acute coronary syndrome patients to ticagrelor versus clopidogrel, patients (n=15 108) with available DM and CKD status were classified into 4 groups: DM+/CKD+ (n=1058), DM+/CKD− (n=2748), DM−/CKD+ (n=2160), and DM−/CKD− (n=9142). The primary efficacy end point was a composite of cardiovascular death, myocardial infarction, or stroke at 12 months. The primary safety end point was PLATO major bleeding. DM+/CKD+ patients had a higher incidence of the primary end point compared with DM−/CKD− patients (23.3% versus 7.1%; adjusted hazard ratio 2.22; 95% CI 1.88–2.63; P<0.001). Patients with DM+/CKD− and DM−/CKD+ had an intermediate risk profile. The same trend was shown for the individual components of the primary end point and for major bleeding. Compared with clopidogrel, ticagrelor reduced the incidence of the primary end point consistently across subgroups (P‐interaction=0.264), but with an increased absolute risk reduction in DM+/CKD+. The effects on major bleeding were also consistent across subgroups (P‐interaction=0.288). Conclusions In acute coronary syndrome patients, a gradient of risk was observed according to the presence or absence of DM and CKD, with patients having both risk factors at the highest risk. Although the ischemic benefit of ticagrelor over clopidogrel was consistent in all subgroups, the absolute risk reduction was greatest in patients with both DM and CKD. Clinical Trial Registration URL: http://www.clinicatrials.gov. Unique identifier: NCT00391872.
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Affiliation(s)
- Francesco Franchi
- 1 University of Florida, College of Medicine-Jacksonville Jacksonville FL
| | - Stefan K James
- 2 Department of Medical Sciences Cardiology Uppsala University Uppsala Sweden.,3 Uppsala Clinical Research Center Uppsala University Uppsala Sweden
| | | | - Andrzej J Budaj
- 4 Postgraduate Medical School Grochowski Hospital Warsaw Poland
| | - Jan H Cornel
- 5 Department of Cardiology Noordwest Ziekenhuisgroep Alkmaar Netherlands
| | - Hugo A Katus
- 6 Medizinishe Klinik Universitätsklinikum Heidelberg Heidelberg Germany
| | - Matyas Keltai
- 7 Hungarian Institute of Cardiology Semmelweis University Budapest Hungary
| | - Frederic Kontny
- 8 Department of Cardiology Stavanger University Hospital Stavanger Norway
| | | | - Robert F Storey
- 10 Department of Infection, Immunity and Cardiovascular Disease University of Sheffield United Kingdom
| | | | - Lars Wallentin
- 2 Department of Medical Sciences Cardiology Uppsala University Uppsala Sweden.,3 Uppsala Clinical Research Center Uppsala University Uppsala Sweden
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15
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Wood DA, Cairns JA, Wang J, Mehran R, Storey RF, Nguyen H, Meeks B, Kunadian V, Tanguay JF, Kim HH, Cheema A, Dehghani P, Natarajan MK, Jolly SS, Amerena J, Keltai M, James S, Hlinomaz O, Niemela K, AlHabib K, Lewis BS, Nguyen M, Sarma J, Dzavik V, Della Siega A, Mehta SR. Timing of Staged Nonculprit Artery Revascularization in Patients With ST-Segment Elevation Myocardial Infarction: COMPLETE Trial. J Am Coll Cardiol 2020; 74:2713-2723. [PMID: 31779786 DOI: 10.1016/j.jacc.2019.09.051] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The COMPLETE (Complete vs Culprit-only Revascularization to Treat Multi-vessel Disease After Early PCI for STEMI) trial demonstrated that staged nonculprit lesion percutaneous coronary intervention (PCI) reduced major cardiovascular (CV) events in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (CAD). OBJECTIVES The purpose of this study was to determine the effect of nonculprit-lesion PCI timing on major CV outcomes and also the time course of the benefit of complete revascularization. METHODS Following culprit-lesion PCI, 4,041 patients with STEMI and multivessel CAD were randomized to staged nonculprit-lesion PCI or culprit-lesion only PCI. Randomization was stratified according to investigator-planned timing of nonculprit-lesion PCI: during or after the index hospitalization. The first coprimary outcome was the composite of CV death or myocardial infarction (MI). In pre-specified analyses, hazard ratios (HRs) were calculated for each time stratum. Landmark analyses of the entire population were performed within 45 days and after 45 days. RESULTS For nonculprit-lesion PCI planned during the index hospitalization (actual time: median 1 day), CV death or MI was reduced with complete revascularization compared with culprit-lesion only PCI (HR: 0.77; 95% confidence interval [CI]: 0.59 to 1.00). For nonculprit lesion PCI planned to occur after hospital discharge (actual time: median 23 days), CV death or MI was also reduced with complete revascularization (HR: 0.69; 95% CI: 0.49 to 0.97; interaction p = 0.62). Landmark analyses demonstrated an HR of 0.86 (95% CI: 0.59 to 1.24) during the first 45 days and 0.69 (95% CI: 0.54 to 0.89) from 45 days to the end of follow-up for intended nonculprit lesion PCI versus culprit lesion only PCI. CONCLUSIONS Among STEMI patients with multivessel disease, the benefit of complete revascularization over culprit-lesion only PCI was consistent irrespective of the investigator-determined timing of nonculprit-lesion intervention. The benefit of complete revascularization on hard clinical outcomes emerged mainly over the long term.
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Affiliation(s)
- David A Wood
- Centre for Cardiovascular Innovation, St. Paul's and Vancouver General Hospitals, University of British Columbia, Vancouver, British Columbia, Canada.
| | - John A Cairns
- Centre for Cardiovascular Innovation, St. Paul's and Vancouver General Hospitals, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jia Wang
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Roxana Mehran
- The Zena A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert F Storey
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Helen Nguyen
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Brandi Meeks
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Vijay Kunadian
- Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University and Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | | | - Hahn-Ho Kim
- St Mary's General Hospital, Kitchener, Ontario, Canada
| | - Asim Cheema
- St. Michael's Hospital, Toronto, Ontario, Canada
| | - Payam Dehghani
- Prairie Vascular Research Network, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - Madhu K Natarajan
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Sanjit S Jolly
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | - Matyas Keltai
- Hungarian Institute of Cardiology, Budapest, Hungary
| | - Stefan James
- Uppsala Clinical Research Centre and Department of Medical Sciences, Uppsala, Sweden
| | - Ota Hlinomaz
- University Hospital St Anne, Brno, Czech Republic
| | - Kari Niemela
- Heart Centre, Tampere University Hospital, Tampere, Finland
| | - Khalid AlHabib
- Department of Cardiac Services, King Fahad Cardiac Center, Saudi Arabia
| | - Basil S Lewis
- Cardiovascular Clinical Research Institute, Lady Davis Carmel Medical Center, Haifa, Israel
| | - Michel Nguyen
- Division of Cardiology, Centre Hospitalier, Universitaire de Sherbrooke, Quebec, Quebec, Canada
| | - Jaydeep Sarma
- North West Heart Centre, Wythenshawe Hospital, Manchester, United Kingdom
| | - Vladimir Dzavik
- Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Anthony Della Siega
- Department of Cardiac Services, Victoria Heart Institute Foundation, Victoria, British Columbia, Canada
| | - Shamir R Mehta
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.
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16
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Maron DJ, Hochman JS, Reynolds HR, Bangalore S, O'Brien SM, Boden WE, Chaitman BR, Senior R, López-Sendón J, Alexander KP, Lopes RD, Shaw LJ, Berger JS, Newman JD, Sidhu MS, Goodman SG, Ruzyllo W, Gosselin G, Maggioni AP, White HD, Bhargava B, Min JK, Mancini GBJ, Berman DS, Picard MH, Kwong RY, Ali ZA, Mark DB, Spertus JA, Krishnan MN, Elghamaz A, Moorthy N, Hueb WA, Demkow M, Mavromatis K, Bockeria O, Peteiro J, Miller TD, Szwed H, Doerr R, Keltai M, Selvanayagam JB, Steg PG, Held C, Kohsaka S, Mavromichalis S, Kirby R, Jeffries NO, Harrell FE, Rockhold FW, Broderick S, Ferguson TB, Williams DO, Harrington RA, Stone GW, Rosenberg Y. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med 2020; 382:1395-1407. [PMID: 32227755 PMCID: PMC7263833 DOI: 10.1056/nejmoa1915922] [Citation(s) in RCA: 1354] [Impact Index Per Article: 338.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, -1.8 percentage points; 95% CI, -4.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA ClinicalTrials.gov number, NCT01471522.).
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Affiliation(s)
- David J Maron
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Judith S Hochman
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Harmony R Reynolds
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Sripal Bangalore
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Sean M O'Brien
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - William E Boden
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Bernard R Chaitman
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Roxy Senior
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Jose López-Sendón
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Karen P Alexander
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Renato D Lopes
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Leslee J Shaw
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Jeffrey S Berger
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Jonathan D Newman
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Mandeep S Sidhu
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Shaun G Goodman
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Witold Ruzyllo
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Gilbert Gosselin
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Aldo P Maggioni
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Harvey D White
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Balram Bhargava
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - James K Min
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - G B John Mancini
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Daniel S Berman
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Michael H Picard
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Raymond Y Kwong
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Ziad A Ali
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Daniel B Mark
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - John A Spertus
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Mangalath N Krishnan
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Ahmed Elghamaz
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Nagaraja Moorthy
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Whady A Hueb
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Marcin Demkow
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Kreton Mavromatis
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Olga Bockeria
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Jesus Peteiro
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Todd D Miller
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Hanna Szwed
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Rolf Doerr
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Matyas Keltai
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Joseph B Selvanayagam
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - P Gabriel Steg
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Claes Held
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Shun Kohsaka
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Stavroula Mavromichalis
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Ruth Kirby
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Neal O Jeffries
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Frank E Harrell
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Frank W Rockhold
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Samuel Broderick
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - T Bruce Ferguson
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - David O Williams
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Robert A Harrington
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Gregg W Stone
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
| | - Yves Rosenberg
- From the Department of Medicine, Stanford University School of Medicine, Stanford (D.J.M., R.A.H.), and Cedars-Sinai Medical Center, Los Angeles (D.S.B.) - both in California; New York University Grossman School of Medicine (J.S.H., H.R.R., S. Bangalore, J.S.B., J.D.N., S.M.), Weill Cornell Medicine/New York-Presbyterian Hospital (L.J.S.), Cleerly (J.K.M.), the Cardiovascular Research Foundation (Z.A.A., G.W.S.), Columbia University Irving Medical Center/New York-Presbyterian Hospital (Z.A.A.), and Icahn School of Medicine at Mount Sinai (G.W.S.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; Duke Clinical Research Institute, Durham (S.M.O., K.P.A., R.D.L., D.B.M., F.W.R., S. Broderick), and Brody School of Medicine, East Carolina University, Greenville (T.B.F.) - both in North Carolina; Veterans Affairs (VA) New England Healthcare System and Boston University School of Medicine (W.E.B.), Massachusetts General Hospital and Harvard Medical School (M.H.P.), and Brigham and Women's Hospital (R.Y.K., D.O.W.) - all in Boston; Saint Louis University School of Medicine, St. Louis (B.R.C.), and the Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City (J.A.S.); Northwick Park Hospital (R.S., A.E.) and Imperial College London and Royal Brompton Hospital (R.S.) - all in London; Hospital Universitario La Paz, Instituto de Investigación de La Paz, Centro de Investigación Biomédica en Red Cardiovascular, Madrid (J.L.-S.), and Complejo Hospitalario Universitario A Coruna, Centro de Investigación Biomédica en Red Cardiovascular, A Coruna (J.P.) - all in Spain; Canadian Heart Research Centre and St. Michael's Hospital, University of Toronto, Toronto (S.G.G.), Montreal Heart Institute Research Center, Montreal (G.G.), and the University of British Columbia, Vancouver (G.B.J.M.) - all in Canada; the Department of Coronary and Structural Heart Diseases (M.D.), National Institute of Cardiology (W.R., M.D., H.S.), Warsaw, Poland; Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy (A.P.M.); Auckland Hospital Green Lane Cardiovascular Services, Auckland, New Zealand (H.D.W.); All India Institute of Medical Sciences, New Delhi (B.B.), Government Medical College Kozhikode, Kerala (M.N.K.), and Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore (N.M.) - all in India; Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo (W.A.H.); Emory University School of Medicine-Atlanta VA Medical Center, Decatur, Georgia (K.M.); the National Research Center for Cardiovascular Surgery, Moscow (O.B.); Mayo Clinic, Rochester, MN (T.D.M.); Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.); Semmelweis University, Budapest, Hungary (M.K.); Flinders University, Flinders Medical Centre, Adelaide, SA, Australia (J.B.S.); Université de Paris, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); the Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Keio University School of Medicine, Shinjuku, Tokyo (S.K.); the National Institutes of Health, Bethesda, MD (R.K., N.O.J., Y.R.); and Vanderbilt University School of Medicine, Nashville (F.E.H.)
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17
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Gerstein HC, Hart R, Colhoun HM, Diaz R, Lakshmanan M, Botros FT, Probstfield J, Riddle MC, Rydén L, Atisso CM, Dyal L, Hall S, Avezum A, Basile J, Conget I, Cushman WC, Hancu N, Hanefeld M, Jansky P, Keltai M, Lanas F, Leiter LA, Lopez-Jaramillo P, Muñoz EGC, Pogosova N, Raubenheimer PJ, Shaw JE, Sheu WHH, Temelkova-Kurktschiev T. The effect of dulaglutide on stroke: an exploratory analysis of the REWIND trial. Lancet Diabetes Endocrinol 2020; 8:106-114. [PMID: 31924562 DOI: 10.1016/s2213-8587(19)30423-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/01/2019] [Accepted: 12/02/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cardiovascular outcome trials have suggested that glucagon-like peptide 1 (GLP-1) receptor agonists might reduce strokes. We analysed the effect of dulaglutide on stroke within the researching cardiovascular events with a weekly incretin in diabetes (REWIND) trial. METHODS REWIND was a multicentre, randomised, double-blind, placebo-controlled trial done at 371 sites in 24 countries. Men and women (aged ≥50 years) with established or newly detected type 2 diabetes whose HbA1c was 9·5% or less (with no lower limit) on stable doses of up to two oral glucose-lowering drugs with or without basal insulin therapy were eligible if their body-mass index was at least 23 kg/m2. Participants were randomly assigned (1:1) to weekly subcutaneous injections of either masked dulaglutide 1·5 mg or the same volume of masked placebo (containing the same excipients but without dulaglutide). Randomisation was done by a computer-generated random code with an interactive web response system with stratification by site. Participants, investigators, the trial leadership, and all other personnel were masked to treatment allocation until the trial was completed and the database was locked. During the treatment period, participants in both groups were instructed to inject study drug on the same day at around the same time, each week. Strokes were categorised as fatal or non-fatal, and as either ischaemic, haemorrhagic, or undetermined. Stroke severity was assessed using the modified Rankin scale. Participants were seen at 2 weeks, 3 months, 6 months, and then every 3 months for drug dispensing and every 6 months for detailed assessments, until 1200 confirmed primary outcomes accrued. The primary endpoint was the first occurrence of any component of the composite outcome, which comprised non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular or unknown causes. All analyses were done according to an intention-to-treat strategy that included all randomly assigned participants, irrespective of adherence. The trial is registered with ClinicalTrials.gov, number NCT01394952. FINDINGS Between Aug 18, 2011, and Aug 14, 2013, we screened 12 133 patients, of whom 9901 with type 2 diabetes and additional cardiovascular risk factors were randomly assigned to either dulaglutide (n=4949) or an equal volume of placebo (n=4952). During a median follow-up of 5·4 years, cerebrovascular and other cardiovascular outcomes were ascertained and adjudicated. 158 (3·2%) of 4949 participants assigned to dulaglutide and 205 (4·1%) of 4952 participants assigned to placebo had a stroke during follow-up (hazard ratio [HR] 0·76, 95% CI 0·62-0·94; p=0·010). Dulaglutide reduced ischaemic stroke (0·75, 0·59-0·94, p=0·012) but had no effect on haemorrhagic stroke (1·05, 0·55-1·99; p=0·89). Dulaglutide also reduced the composite of non-fatal stroke or all-cause death (0·88, 0·79-0·98; p=0·017) and disabling stroke (0·74, 0·56-0·99; p=0·042). The degree of disability after stroke did not differ by treatment group. INTERPRETATION Long-term dulaglutide use might reduce clinically relevant ischaemic stroke in people with type 2 diabetes but does not affect stroke severity. FUNDING Eli Lilly and Company.
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Affiliation(s)
- Hertzel C Gerstein
- Population Health Research Institute, Hamilton, ON, Canada; Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
| | - Robert Hart
- Population Health Research Institute, Hamilton, ON, Canada
| | | | - Rafael Diaz
- Estudios Clínicos Latino América, Rosario, Argentina
| | | | | | | | - Matthew C Riddle
- Department of Medicine, Oregon Health & Science University Portland, OR, USA
| | - Lars Rydén
- Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden
| | | | - Leanne Dyal
- Population Health Research Institute, Hamilton, ON, Canada
| | - Stephanie Hall
- Population Health Research Institute, Hamilton, ON, Canada
| | | | - Jan Basile
- Medical University of South Carolina, Ralph H Johnson VA Medical Center, Charleston, SC, USA
| | - Ignacio Conget
- Endocrinology and Nutrition Department, Hospital Clínic i Universitari, Barcelona, Spain
| | | | - Nicolae Hancu
- Department of Diabetes and Nutrition, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Markolf Hanefeld
- Department of Internal Medicine, Dresden Technical University, Dresden, Germany
| | - Petr Jansky
- University Hospital Motol, Prague, Czech Republic
| | - Matyas Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary
| | - Fernando Lanas
- Department of Internal Medicine, Universidad de La Frontera, Temuco, Chile
| | - Lawrence A Leiter
- Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Patricio Lopez-Jaramillo
- Masira Research Institute, Medical School, Universidad de Santander UDES and FOSCAL, Bucaramanga, Colombia
| | | | - Nana Pogosova
- National Medical Research Center of Cardiology, Moscow, Russia
| | | | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
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18
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Hijazi Z, Granger CB, Hohnloser SH, Westerbergh J, Lindback J, Alexander JH, Keltai M, Parkhomenko A, Lopez-Sendon JL, Lopes RD, Siegbahn A, Wallentin L. P4747Impact of different estimates of renal function on cardiovascular mortality and major bleeding in patients with atrial fibrillation on oral anticoagulation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Renal dysfunction is associated with increased risk of cardiovascular events in atrial fibrillation (AF). Estimated glomerular filtration rate (eGFR) can be calculated by different equations based on creatinine or cystatin C. We compared different methods of assessing eGFR and their association with cardiovascular (CV) death and major bleeding in 14,980 AF patients in the ARISTOTLE trial.
Methods
eGFR was calculated using equations based on creatinine (Cockcroft-Gault, MDRD, and CKD-EPI) and/or cystatin C (CKD-EPIcys and CKD-EPIcys+crea). In total five eGFR equations as well as a model based on the variables within the equations were assessed. Associations were evaluated by Spearman correlation, and discriminatory ability for CV-death and major bleeding by Harrell's c-index.
Results
Median age was 70.0 years, and 35.6% were women. Median eGFR (mL/min) were: Cockcroft-Gault 74.1, MDRD 66.5, CKD-EPI 68.5, CKD-EPIcys 74.2, and CKD-EPIcys+crea 72.6. Correlation ranged from 0.49 (Cockroft-Gault and CKD-EPIcys) to 0.99 (MDRD and CKD-EPI). Among the eGFR equations, those based on cystatin C yielded the highest c-indices for CV-death and major bleeding, 0.628 (CKD-EPIcys) and 0.612 (CKD-EPIcys+crea), respectively. A model based on the variables within the eGFR equations (age, sex, weight, creatinine, and cystatin C) yielded the highest discriminatory value for both outcomes, 0.673 and 0.656, respectively.
Figure 1
Conclusions
In patients with AF on anticoagulation, correlation between eGFR methods varied greatly. Cystatin C-based eGFR seem to provide the most robust balance in reflecting the risk of death and bleeding. However, a model based on the individual variables within the eGFR equations provided the highest discriminatory value.
Acknowledgement/Funding
The ARISTOTLE trial was funded by Bristol-Myers Squibb, Co Princeton, NJ and Pfizer Inc., New York, NY.
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Affiliation(s)
- Z Hijazi
- Uppsala University, UCR-Uppsala Clinical Research Center, Uppsala, Sweden
| | - C B Granger
- Duke Clinical Research Institute, Durham, United States of America
| | - S H Hohnloser
- Wolfgang Goethe University, Frankfurt am Main, Germany
| | - J Westerbergh
- Uppsala University, UCR-Uppsala Clinical Research Center, Uppsala, Sweden
| | - J Lindback
- Uppsala University, UCR-Uppsala Clinical Research Center, Uppsala, Sweden
| | - J H Alexander
- Duke Clinical Research Institute, Durham, United States of America
| | - M Keltai
- Semmelweis University, Budapest, Hungary
| | | | | | - R D Lopes
- Duke Clinical Research Institute, Durham, United States of America
| | - A Siegbahn
- Duke Clinical Research Institute, Durham, United States of America
| | - L Wallentin
- Uppsala University, Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala, Sweden
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19
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Moayyedi P, Eikelboom JW, Bosch J, Connolly SJ, Dyal L, Shestakovska O, Leong D, Anand SS, Störk S, Branch KRH, Bhatt DL, Verhamme PB, O'Donnell M, Maggioni AP, Lonn EM, Piegas LS, Ertl G, Keltai M, Bruns NC, Muehlhofer E, Dagenais GR, Kim JH, Hori M, Steg PG, Hart RG, Diaz R, Alings M, Widimsky P, Avezum A, Probstfield J, Zhu J, Liang Y, Lopez-Jaramillo P, Kakkar AK, Parkhomenko AN, Ryden L, Pogosova N, Dans AL, Lanas F, Commerford PJ, Torp-Pedersen C, Guzik TJ, Vinereanu D, Tonkin AM, Lewis BS, Felix C, Yusoff K, Metsarinne KP, Fox KAA, Yusuf S. Safety of Proton Pump Inhibitors Based on a Large, Multi-Year, Randomized Trial of Patients Receiving Rivaroxaban or Aspirin. Gastroenterology 2019; 157:682-691.e2. [PMID: 31152740 DOI: 10.1053/j.gastro.2019.05.056] [Citation(s) in RCA: 249] [Impact Index Per Article: 49.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/18/2019] [Accepted: 05/21/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Proton pump inhibitors (PPIs) are effective at treating acid-related disorders. These drugs are well tolerated in the short term, but long-term treatment was associated with adverse events in observational studies. We aimed to confirm these findings in an adequately powered randomized trial. METHODS We performed a 3 × 2 partial factorial double-blind trial of 17,598 participants with stable cardiovascular disease and peripheral artery disease randomly assigned to groups given pantoprazole (40 mg daily, n = 8791) or placebo (n = 8807). Participants were also randomly assigned to groups that received rivaroxaban (2.5 mg twice daily) with aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg) alone. We collected data on development of pneumonia, Clostridium difficile infection, other enteric infections, fractures, gastric atrophy, chronic kidney disease, diabetes, chronic obstructive lung disease, dementia, cardiovascular disease, cancer, hospitalizations, and all-cause mortality every 6 months. Patients were followed up for a median of 3.01 years, with 53,152 patient-years of follow-up. RESULTS There was no statistically significant difference between the pantoprazole and placebo groups in safety events except for enteric infections (1.4% vs 1.0% in the placebo group; odds ratio, 1.33; 95% confidence interval, 1.01-1.75). For all other safety outcomes, proportions were similar between groups except for C difficile infection, which was approximately twice as common in the pantoprazole vs the placebo group, although there were only 13 events, so this difference was not statistically significant. CONCLUSIONS In a large placebo-controlled randomized trial, we found that pantoprazole is not associated with any adverse event when used for 3 years, with the possible exception of an increased risk of enteric infections. ClinicalTrials.gov Number: NCT01776424.
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Affiliation(s)
- Paul Moayyedi
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.
| | - John W Eikelboom
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Jackie Bosch
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Stuart J Connolly
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Leanne Dyal
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Olga Shestakovska
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Darryl Leong
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Sonia S Anand
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Stefan Störk
- University of Würzburg and University Hospital, Würzburg, Germany
| | | | - Deepak L Bhatt
- Brigham and Women's Hospital, Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts
| | | | | | - Aldo P Maggioni
- Cardiologists Research Center, Associazione Nazionale Medici Cardiologi Ospedalieri, Florence, Italy
| | - Eva M Lonn
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | - Georg Ertl
- University of Würzburg and University Hospital, Würzburg, Germany
| | | | | | | | - Gilles R Dagenais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, Québec, Canada
| | | | | | - P Gabriel Steg
- University Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Robert G Hart
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Rafael Diaz
- Estudios Clinicos Latino America and Instituto Cardiovascular de Rosario, Rosario, Argentina
| | - Marco Alings
- Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland, Utrecht, The Netherlands
| | - Petr Widimsky
- Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alvaro Avezum
- Instituto Dante Pazzanese de Cardiologia Sao Paulo, Brazil
| | | | - Jun Zhu
- FuWai Hospital, Beijing, China
| | | | - Patricio Lopez-Jaramillo
- National Association of Hospital Research Institute, Fundaciun Oftalmoligica de Santander-Bucaramanga, Bucaramanga, Colombia
| | - Ajay K Kakkar
- Thrombosis Research Institute and University College London, London, UK
| | | | - Lars Ryden
- Karolinska Institutet, Stockholm, Sweden
| | - Nana Pogosova
- National Research Center for Preventative Medicine, Moscow, Russia
| | | | | | | | | | - Tomek J Guzik
- University of Glasgow, Glasgow, UK; Collegium Medicum Jagiellonian University, Krakow, Poland
| | - Dragos Vinereanu
- University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania
| | | | | | - Camilo Felix
- Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnoligica Equinoccial, Quito, Ecuador
| | | | - Kaj P Metsarinne
- Turku University Central Hospital and Turku University, Turku, Finland
| | - Keith A A Fox
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Salim Yusuf
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
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20
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Moayyedi P, Eikelboom JW, Bosch J, Connolly SJ, Dyal L, Shestakovska O, Leong D, Anand SS, Störk S, Branch KRH, Bhatt DL, Verhamme PB, O'Donnell M, Maggioni AP, Lonn EM, Piegas LS, Ertl G, Keltai M, Cook Bruns N, Muehlhofer E, Dagenais GR, Kim JH, Hori M, Steg PG, Hart RG, Diaz R, Alings M, Widimsky P, Avezum A, Probstfield J, Zhu J, Liang Y, Lopez-Jaramillo P, Kakkar A, Parkhomenko AN, Ryden L, Pogosova N, Dans A, Lanas F, Commerford PJ, Torp-Pedersen C, Guzik T, Vinereanu D, Tonkin AM, Lewis BS, Felix C, Yusoff K, Metsarinne K, Fox KAA, Yusuf S. Pantoprazole to Prevent Gastroduodenal Events in Patients Receiving Rivaroxaban and/or Aspirin in a Randomized, Double-Blind, Placebo-Controlled Trial. Gastroenterology 2019; 157:403-412.e5. [PMID: 31054846 DOI: 10.1053/j.gastro.2019.04.041] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Antiplatelets and anticoagulants are associated with increased upper gastrointestinal bleeding. We evaluated whether proton pump inhibitor therapy could reduce this risk. METHODS We performed a 3 × 2 partial factorial double-blind trial of 17,598 participants with stable cardiovascular disease and peripheral artery disease. Participants were randomly assigned to groups given pantoprazole 40 mg daily or placebo, as well as rivaroxaban 2.5 mg twice daily with aspirin 100 mg once daily, rivaroxaban 5 mg twice daily, or aspirin 100 mg alone. The primary outcome was time to first upper gastrointestinal event, defined as a composite of overt bleeding, upper gastrointestinal bleeding from a gastroduodenal lesion or of unknown origin, occult bleeding, symptomatic gastroduodenal ulcer or ≥5 erosions, upper gastrointestinal obstruction, or perforation. RESULTS There was no significant difference in upper gastrointestinal events between the pantoprazole group (102 of 8791 events) and the placebo group (116 of 8807 events) (hazard ratio, 0.88; 95% confidence interval [CI], 0.67-1.15). Pantoprazole significantly reduced bleeding of gastroduodenal lesions (hazard ratio, 0.52; 95% confidence interval, 0.28-0.94; P = .03); this reduction was greater when we used a post-hoc definition of bleeding gastroduodenal lesion (hazard ratio, 0.45; 95% confidence interval, 0.27-0.74), although the number needed to treat still was high (n = 982; 95% confidence interval, 609-2528). CONCLUSIONS In a randomized placebo-controlled trial, we found that routine use of proton pump inhibitors in patients receiving low-dose anticoagulation and/or aspirin for stable cardiovascular disease does not reduce upper gastrointestinal events, but may reduce bleeding from gastroduodenal lesions. ClinicalTrials.gov ID: NCT01776424.
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Affiliation(s)
- Paul Moayyedi
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.
| | - John W Eikelboom
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Jackie Bosch
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Stuart J Connolly
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Leanne Dyal
- University of Philippines, Manila, Philippines
| | - Olga Shestakovska
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Darryl Leong
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Sonia S Anand
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Stefan Störk
- University of Würzburg and University Hospital, Würzburg, Germany
| | | | - Deepak L Bhatt
- Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts
| | | | | | - Aldo P Maggioni
- National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy
| | - Eva M Lonn
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada; Bayer, Leverkusen, Germany
| | | | - Georg Ertl
- University of Würzburg and University Hospital, Würzburg, Germany
| | | | | | | | - Gilles R Dagenais
- Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Canada
| | | | | | | | - Robert G Hart
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Rafael Diaz
- Estudios Clinicos Latino America and Instituto Cardiovascular de Rosario, Rosario, Argentina
| | - Marco Alings
- Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands
| | - Petr Widimsky
- Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alvaro Avezum
- Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
| | | | - Jun Zhu
- FuWai Hospital, Beijing, China
| | | | - Patricio Lopez-Jaramillo
- Research Institute, Fundaciun Oftalmoligica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia
| | - Ajay Kakkar
- Thrombosis Research Institute and University College London, London, UK
| | | | - Lars Ryden
- Karolinska Institutet, Stockholm, Sweden
| | - Nana Pogosova
- National Research Center for Preventative Medicine, Moscow, Russia
| | - Antonio Dans
- College of Medicine, University of the Philippines-Manila, Ermita, Manila, Philippines
| | | | | | | | - Tomek Guzik
- University of Glasgow, Glasgow, UK; Collegium Medicum Jagiellonian University, Krakow, Poland
| | - Dragos Vinereanu
- University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania
| | | | | | - Camilo Felix
- Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnoligica Equinoccial, Quito, Ecuador
| | | | - Kaj Metsarinne
- Universit Paris Diderot, Hopital Bichat, Assistance Publique, Paris, France; Turku University Central Hospital and Turku University, Turku, Finland
| | - Keith A A Fox
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Salim Yusuf
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
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21
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Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, Probstfield J, Riesmeyer JS, Riddle MC, Rydén L, Xavier D, Atisso CM, Dyal L, Hall S, Rao-Melacini P, Wong G, Avezum A, Basile J, Chung N, Conget I, Cushman WC, Franek E, Hancu N, Hanefeld M, Holt S, Jansky P, Keltai M, Lanas F, Leiter LA, Lopez-Jaramillo P, Cardona Munoz EG, Pirags V, Pogosova N, Raubenheimer PJ, Shaw JE, Sheu WHH, Temelkova-Kurktschiev T. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet 2019; 394:121-130. [PMID: 31189511 DOI: 10.1016/s0140-6736(19)31149-3] [Citation(s) in RCA: 1356] [Impact Index Per Article: 271.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 04/26/2019] [Accepted: 04/28/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Three different glucagon-like peptide-1 (GLP-1) receptor agonists reduce cardiovascular outcomes in people with type 2 diabetes at high cardiovascular risk with high glycated haemoglobin A1c (HbA1c) concentrations. We assessed the effect of the GLP-1 receptor agonist dulaglutide on major adverse cardiovascular events when added to the existing antihyperglycaemic regimens of individuals with type 2 diabetes with and without previous cardiovascular disease and a wide range of glycaemic control. METHODS This multicentre, randomised, double-blind, placebo-controlled trial was done at 371 sites in 24 countries. Men and women aged at least 50 years with type 2 diabetes who had either a previous cardiovascular event or cardiovascular risk factors were randomly assigned (1:1) to either weekly subcutaneous injection of dulaglutide (1·5 mg) or placebo. Randomisation was done by a computer-generated random code with stratification by site. All investigators and participants were masked to treatment assignment. Participants were followed up at least every 6 months for incident cardiovascular and other serious clinical outcomes. The primary outcome was the first occurrence of the composite endpoint of non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular causes (including unknown causes), which was assessed in the intention-to-treat population. This study is registered with ClinicalTrials.gov, number NCT01394952. FINDINGS Between Aug 18, 2011, and Aug 14, 2013, 9901 participants (mean age 66·2 years [SD 6·5], median HbA1c 7·2% [IQR 6·6-8·1], 4589 [46·3%] women) were enrolled and randomly assigned to receive dulaglutide (n=4949) or placebo (n=4952). During a median follow-up of 5·4 years (IQR 5·1-5·9), the primary composite outcome occurred in 594 (12·0%) participants at an incidence rate of 2·4 per 100 person-years in the dulaglutide group and in 663 (13·4%) participants at an incidence rate of 2·7 per 100 person-years in the placebo group (hazard ratio [HR] 0·88, 95% CI 0·79-0·99; p=0·026). All-cause mortality did not differ between groups (536 [10·8%] in the dulaglutide group vs 592 [12·0%] in the placebo group; HR 0·90, 95% CI 0·80-1·01; p=0·067). 2347 (47·4%) participants assigned to dulaglutide reported a gastrointestinal adverse event during follow-up compared with 1687 (34·1%) participants assigned to placebo (p<0·0001). INTERPRETATION Dulaglutide could be considered for the management of glycaemic control in middle-aged and older people with type 2 diabetes with either previous cardiovascular disease or cardiovascular risk factors. FUNDING Eli Lilly and Company.
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Affiliation(s)
- Hertzel C Gerstein
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
| | | | - Gilles R Dagenais
- Institut Universitaire de Cardiologie et Pneumologie, Université Laval, Québec City, QC, Canada
| | - Rafael Diaz
- ECLA, Estudios Clínicos Latinoamérica, Rosario, Argentina
| | | | - Prem Pais
- St John's Research Institute, Bangalore, India
| | | | | | - Matthew C Riddle
- Department of Medicine, Oregon Health & Science University Portland, OR, USA
| | - Lars Rydén
- Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Leanne Dyal
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Stephanie Hall
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Purnima Rao-Melacini
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Gloria Wong
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Alvaro Avezum
- Instituto Dante Pazzanese de Cardiologia and University Santo Amaro, São Paulo, Brazil
| | - Jan Basile
- Medical University of South Carolina, Charleston, SC, USA
| | - Namsik Chung
- Yonsei University Health System, Seoul, South Korea
| | - Ignacio Conget
- Endocrinology and Nutrition Department, Hospital Clínic i Universitari, Barcelona, Spain
| | | | - Edward Franek
- Mossakowski Medical Research Centre, Polish Academy of Sciences and Central Clinical Hospital MSWiA, Warsaw, Poland
| | - Nicolae Hancu
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Markolf Hanefeld
- Department of Internal Medicine, Dresden Technical University, Dresden, Germany
| | - Shaun Holt
- Victoria University of Wellington, Wellington, New Zealand
| | - Petr Jansky
- University Hospital Motol, Prague, Czech Republic
| | - Matyas Keltai
- Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary
| | | | - Lawrence A Leiter
- Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Patricio Lopez-Jaramillo
- Research Institute, FOSCAL and Medical School, Universidad de Santander UDES, Bucaramanga, Colombia
| | | | | | - Nana Pogosova
- National Medical Research Center of Cardiology, Moscow, Russia
| | | | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
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22
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Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, Probstfield J, Botros FT, Riddle MC, Rydén L, Xavier D, Atisso CM, Dyal L, Hall S, Rao-Melacini P, Wong G, Avezum A, Basile J, Chung N, Conget I, Cushman WC, Franek E, Hancu N, Hanefeld M, Holt S, Jansky P, Keltai M, Lanas F, Leiter LA, Lopez-Jaramillo P, Cardona Munoz EG, Pirags V, Pogosova N, Raubenheimer PJ, Shaw JE, Sheu WHH, Temelkova-Kurktschiev T. Dulaglutide and renal outcomes in type 2 diabetes: an exploratory analysis of the REWIND randomised, placebo-controlled trial. Lancet 2019; 394:131-138. [PMID: 31189509 DOI: 10.1016/s0140-6736(19)31150-x] [Citation(s) in RCA: 325] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 04/26/2019] [Accepted: 04/28/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Two glucagon-like peptide-1 (GLP-1) receptor agonists reduced renal outcomes in people with type 2 diabetes at risk for cardiovascular disease. We assessed the long-term effect of the GLP-1 receptor agonist dulaglutide on renal outcomes in an exploratory analysis of the REWIND trial of the effect of dulaglutide on cardiovascular disease. METHODS REWIND was a multicentre, randomised, double-blind, placebo-controlled trial at 371 sites in 24 countries. Men and women aged at least 50 years with type 2 diabetes who had either a previous cardiovascular event or cardiovascular risk factors were randomly assigned (1:1) to either weekly subcutaneous injection of dulaglutide (1·5 mg) or placebo and followed up at least every 6 months for outcomes. Urinary albumin-to-creatinine ratios (UACRs) and estimated glomerular filtration rates (eGFRs) were estimated from urine and serum values measured in local laboratories every 12 months. The primary outcome (first occurrence of the composite endpoint of non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular causes), secondary outcomes (including a composite microvascular outcome), and safety outcomes of this trial have been reported elsewhere. In this exploratory analysis, we investigate the renal component of the composite microvascular outcome, defined as the first occurrence of new macroalbuminuria (UACR >33·9 mg/mmol), a sustained decline in eGFR of 30% or more from baseline, or chronic renal replacement therapy. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01394952. FINDINGS Between Aug 18, 2011, and Aug 14, 2013, 9901 participants were enrolled and randomly assigned to receive dulaglutide (n=4949) or placebo (n=4952). At baseline, 791 (7·9%) had macroalbuminuria and mean eGFR was 76·9 mL/min per 1·73 m2 (SD 22·7). During a median follow-up of 5·4 years (IQR 5·1-5·9) comprising 51 820 person-years, the renal outcome developed in 848 (17·1%) participants at an incidence rate of 3·5 per 100 person-years in the dulaglutide group and in 970 (19·6%) participants at an incidence rate of 4·1 per 100 person-years in the placebo group (hazard ratio [HR] 0·85, 95% CI 0·77-0·93; p=0·0004). The clearest effect was for new macroalbuminuria (HR 0·77, 95% CI 0·68-0·87; p<0·0001), with HRs of 0·89 (0·78-1·01; p=0·066) for sustained decline in eGFR of 30% or more and 0·75 (0·39-1·44; p=0·39) for chronic renal replacement therapy. INTERPRETATION Long-term use of dulaglutide was associated with reduced composite renal outcomes in people with type 2 diabetes. FUNDING Eli Lilly and Company.
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Affiliation(s)
- Hertzel C Gerstein
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
| | | | - Gilles R Dagenais
- Institut Universitaire de Cardiologie et Pneumologie, Université Laval, Québec City, QC, Canada
| | - Rafael Diaz
- ECLA, Estudios Clínicos Latinoamérica, Rosario, Argentina
| | | | - Prem Pais
- St John's Research Institute, Bangalore, India
| | | | | | - Matthew C Riddle
- Department of Medicine, Oregon Health & Science University Portland, OR, USA
| | - Lars Rydén
- Department of Medicine K2, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Leanne Dyal
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Stephanie Hall
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Purnima Rao-Melacini
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Gloria Wong
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Alvaro Avezum
- Instituto Dante Pazzanese de Cardiologia and University Santo Amaro, São Paulo, Brazil
| | - Jan Basile
- Medical University of South Carolina, Charleston, SC, USA
| | - Namsik Chung
- Yonsei University Health System, Seoul, South Korea
| | - Ignacio Conget
- Endocrinology and Nutrition Department, Hospital Clínic i Universitari, Barcelona, Spain
| | | | - Edward Franek
- Mossakowski Medical Research Centre, Polish Academy of Sciences and Central Clinical Hospital MSWiA, Warsaw, Poland
| | - Nicolae Hancu
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Markolf Hanefeld
- Department of Internal Medicine, Dresden Technical University, Dresden, Germany
| | - Shaun Holt
- Victoria University of Wellington, Wellington, New Zealand
| | - Petr Jansky
- University Hospital Motol, Prague, Czech Republic
| | - Matyas Keltai
- Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary
| | | | - Lawrence A Leiter
- Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Patricio Lopez-Jaramillo
- Research Institute, FOSCAL and Medical School, Universidad de Santander UDES, Bucaramanga, Colombia
| | | | | | - Nana Pogosova
- National Medical Research Center of Cardiology, Moscow, Russia
| | | | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
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Sharma M, Hart RG, Smith EE, Bosch J, Yuan F, Casanova A, Eikelboom JW, Connolly SJ, Wong G, Diaz R, Lopez-Jaramillo P, Ertl G, Störk S, Dagenais GR, Lonn EM, Ryden L, Tonkin AM, Varigos JD, Bhatt DL, Branch KR, Probstfield JL, Kim JH, Ha JW, O'Donnell M, Vinereanu D, Fox KA, Liang Y, Liu L, Zhu J, Pogosova N, Maggioni AP, Avezum A, Piegas LS, Keltai K, Keltai M, Cook Bruns N, Berkowitz S, Yusuf S. Rationale, design, and baseline participant characteristics in the MRI and cognitive substudy of the cardiovascular outcomes for people using anticoagulation strategies trial. Int J Stroke 2019; 14:270-281. [PMID: 30058959 DOI: 10.1177/1747493018784478] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND Covert vascular disease of the brain manifests as infarcts, white matter hyperintensities, and microbleeds on MRI. Their cumulative effect is often a decline in cognition, motor impairment, and psychiatric disorders. Preventive therapies for covert brain ischemia have not been established but represent a huge unmet clinical need. AIMS The MRI substudy examines the effects of the antithrombotic regimens in COMPASS on incident covert brain infarcts (the primary outcome), white matter hyperintensities, and cognitive and functional status in a sample of consenting COMPASS participants without contraindications to MRI. METHODS COMPASS is a randomized superiority trial testing rivaroxaban 2.5 mg bid plus acetylsalicylic acid 100 mg and rivaroxaban 5 mg bid against acetylsalicylic acid 100 mg per day for the combined endpoint of MI, stroke, and cardiovascular death in individuals with stable coronary artery disease or peripheral artery disease. T1-weighted, T2-weighted, T2*-weighted, and FLAIR images were obtained close to randomization and near the termination of assigned antithrombotic therapy; biomarker and genetic samples at randomization and one month, and cognitive and functional assessment at randomization, after two years and at the end of study. RESULTS Between March 2013 and May 2016, 1905 participants were recruited from 86 centers in 16 countries. Of these participants, 1760 underwent baseline MRI scans that were deemed technically adequate for interpretation. The mean age at entry of participants with interpretable MRI was 71 years and 23.5% were women. Coronary artery disease was present in 90.4% and 28.1% had peripheral artery disease. Brain infarcts were present in 34.8%, 29.3% had cerebral microbleeds, and 93.0% had white matter hyperintensities. The median Montreal Cognitive Assessment score was 26 (interquartile range 23-28). CONCLUSIONS The COMPASS MRI substudy will examine the effect of the antithrombotic interventions on MRI-determined covert brain infarcts and cognition. Demonstration of a therapeutic effect of the antithrombotic regimens on brain infarcts would have implications for prevention of cognitive decline and provide insight into the pathogenesis of vascular cognitive decline.
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Affiliation(s)
- Mukul Sharma
- 1 Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Robert G Hart
- 1 Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Eric E Smith
- 2 Hotchkiss Brain Institute, University of Calgary, Calgary Canada
| | - Jackie Bosch
- 1 Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
- 3 School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Fei Yuan
- 1 Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Amparo Casanova
- 1 Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - John W Eikelboom
- 1 Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Stuart J Connolly
- 1 Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Gloria Wong
- 1 Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Rafael Diaz
- 3 School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- 4 Estudios Clínicos Latino America and Instituto Cardiovascular de Rosario, Rosario, Argentina
| | | | - Georg Ertl
- 6 Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany
| | - Stefan Störk
- 6 Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany
| | - Gilles R Dagenais
- 7 Institut Universitaire de Cardiologie et Pneumologie de Quebec, Quebec City, Quebec, Canada
| | - Eva M Lonn
- 1 Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Lars Ryden
- 8 Karolinska Institutet, Stockholm, Sweden
| | | | | | - Deepak L Bhatt
- 10 Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Jong-Won Ha
- 14 Yonsei University College of Medicine, Seoul, Korea
| | | | - Dragos Vinereanu
- 16 University of Medicine and Pharmacology Carol Davila University and Emergency Hospital, Bucharest, Romania
| | - Keith Aa Fox
- 17 Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland
| | | | | | - Jun Zhu
- 18 FuWai Hospital, Beijing, China
| | - Nana Pogosova
- 19 National Research Centre for Preventative Medicine (Moscow), Moscow, Russia
| | | | - Alvaro Avezum
- 21 Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
| | | | | | | | | | | | - Salim Yusuf
- 1 Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
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Farsky PS, White J, Sueta C, Dabrowski R, Djokovic L, Drazner M, Haddad H, Ali I, Keltai M, Naik A, Sopko G, Golba K, Andersson B, Carson P, Kukulski T, Al-Khalidi H, Rouleau J, Velazquez E. OPTIMAL MEDICAL THERAPY USE AND LONG-TERM OUTCOMES IN CABG-ELIGIBLE HEART FAILURE PATIENTS: INSIGHTS FROM THE STICH TRIAL. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)30654-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bosch J, O'Donnell M, Swaminathan B, Lonn EM, Sharma M, Dagenais G, Diaz R, Khunti K, Lewis BS, Avezum A, Held C, Keltai M, Reid C, Toff WD, Dans A, Leiter LA, Sliwa K, Lee SF, Pogue JM, Hart R, Yusuf S. Effects of blood pressure and lipid lowering on cognition: Results from the HOPE-3 study. Neurology 2019; 92:e1435-e1446. [PMID: 30814321 DOI: 10.1212/wnl.0000000000007174] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 11/15/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess whether long-term treatment with candesartan/hydrochlorothiazide, rosuvastatin, or their combination can slow cognitive decline in older people at intermediate cardiovascular risk. METHODS The Heart Outcomes Prevention Evaluation-3 (HOPE-3) study was a double-blind, randomized, placebo-controlled clinical trial using a 2 × 2 factorial design. Participants without known cardiovascular disease or need for treatment were randomized to candesartan (16 mg) plus hydrochlorothiazide (12.5 mg) or placebo and to rosuvastatin (10 mg) or placebo. Participants who were ≥70 years of age completed the Digit Symbol Substitution Test (DSST), the modified Montreal Cognitive Assessment, and the Trail Making Test Part B at baseline and study end. RESULTS Cognitive assessments were completed by 2,361 participants from 228 centers in 21 countries. Compared with placebo, candesartan/hydrochlorothiazide reduced systolic blood pressure by 6.0 mm Hg, and rosuvastatin reduced low-density lipoprotein cholesterol by 24.8 mg/dL. Participants were followed up for 5.7 years (median), and 1,626 completed both baseline and study-end assessments. Mean participant age was 74 years (SD ±3.5 years); 59% were women; 45% had hypertension; and 24% had ≥12 years of education. The mean difference in change in DSST scores was -0.91 (95% confidence interval [CI] -2.25 to 0.42) for candesartan/hydrochlorothiazide compared with placebo, -0.54 (95% CI -1.88 to 0.80) for rosuvastatin compared with placebo, and -1.43 (95% CI -3.37 to 0.50) for combination therapy vs double placebo. No significant differences were found for other measures. CONCLUSIONS Long-term blood pressure lowering with candesartan plus hydrochlorothiazide, rosuvastatin, or their combination did not significantly affect cognitive decline in older people. CLINICALTRIALSGOV IDENTIFIER NCT00468923. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that for older people, candesartan plus hydrochlorothiazide, rosuvastatin, or their combination does not significantly affect cognitive decline.
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Affiliation(s)
- Jackie Bosch
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa.
| | - Martin O'Donnell
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Balakumar Swaminathan
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Eva Marie Lonn
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Mikul Sharma
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Gilles Dagenais
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Rafael Diaz
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Kamlesh Khunti
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Basil S Lewis
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Alvaro Avezum
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Claes Held
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Matyas Keltai
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Christopher Reid
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - William D Toff
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Antonio Dans
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Lawrence A Leiter
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Karen Sliwa
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Shun Fu Lee
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Janice M Pogue
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Robert Hart
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
| | - Salim Yusuf
- From the Population Health Research Institute (J.B., M. O., B.S., E.M.L., M.S., S.F.L., J.M.P., R.H., S.Y.) and Hamilton Health Sciences (J.B.), School of Rehabilitation Science, McMaster University, Ontario; Institut Universitaire de Cardiologie et Pneumologie de Québec (G.D.), Université Laval, Québec; Li Ka Shing Knowledge Institute (L.A.L.), St. Michael's Hospital, University of Toronto, Ontario, Canada; Research Board Clinical Research Facility (M.O.), Department of Medicine, NUI Galway, Ireland; Instituto Cardiovascular de Rosario (R.D.), Argentina; Diabetes Research Centre (K.K.), University of Leicester; Department of Cardiovascular Sciences and the National Institute for Health Research (W.D.T.), Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, UK; College of Medicine (A.D.), University of the Philippines, Manila, Philippines; Lady Davis Carmel Medical Center (B.S.L.), Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa; Dante Pazzanese Institute of Cardiology (A.A.), São Paulo, Brazil; Department of Medical Sciences (C.H.), Cardiology, Uppsala Clinical Research Center, Uppsala University, Sweden; Semmelweis University (M.K.), Budapest, Hungary; Monash University (C.R.), Melbourne, Victoria; School of Public Health (C.M.R.), Curtin University, Perth, Australia; and Hatter Institute for Cardiovascular Research in Africa (K.S.), Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, South Africa
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Joseph P, Lonn E, Bosch J, Lopez P, Zhu J, Keltai M, Dans A, Reid C, Khunti K, Toff W, Piegas L, Kim JH, Swaminathan B, Bohm M, Yusuf S. Long-term Effects of Statins, Blood Pressure-Lowering, and Both on Erectile Function in Persons at Intermediate Risk for Cardiovascular Disease: A Substudy of the Heart Outcomes Prevention Evaluation-3 (HOPE-3) Randomized Controlled Trial. Can J Cardiol 2018; 34:38-44. [PMID: 29275880 DOI: 10.1016/j.cjca.2017.09.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 09/27/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND It is unclear whether modifying cholesterol, blood pressure, or both affect erectile dysfunction. Also, there are concerns that erectile dysfunction is worsened by common medications used to treat these risk factors. In this study, we evaluated the effect of: (1) cholesterol-lowering with a statin; (2) pharmacologic blood pressure reduction; and (3) their combination, on erectile function. METHODS A priori, this was a secondary analysis of the Heart Outcomes Prevention Evaluation-3 (HOPE-3) randomized controlled trial. Men were 55 years of age or older with at least 1 cardiovascular risk factor. Erectile function was measured using the erectile function domain of the International Index of Erectile Function (IIEF-EF) score. Men with incomplete scores, or who did not engage in sexual activity, were excluded. Using a 2 × 2 factorial design, participants were randomized to rosuvastatin (10 mg/d) or placebo, and to candesartan with hydrochlorothiazide (HCTZ; 16 mg/12.5 mg/d; Cand+HCTZ) or placebo. Primary outcome was change in IIEF-EF from baseline to end of study follow-up. RESULTS Two thousand one hundred fifty-three men were included; mean age was 61.5 years, and mean follow-up was 5.8 years. Mean IIEF-EF score at baseline was 23.0 (SD 5.6). Least square mean change in the IIEF-EF score did not differ with rosuvastatin compared with placebo (-1.4; standard error [SE], 0.3 vs -1.5; SE, 0.3; P = 0.74), Cand+HCTZ compared with placebo (-1.6; SE, 0.3 vs -1.3; SE, 0.3; P = 0.10), or combination therapy compared with double placebo (P = 0.35). CONCLUSIONS Cholesterol-lowering using a statin, and blood pressure-lowering using Cand+HCTZ, either alone or in combination, do not improve or adversely affect erectile function.
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Affiliation(s)
- Philip Joseph
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
| | - Eva Lonn
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Jackie Bosch
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Patricio Lopez
- Research Institute FOSCAL, Medical School, Universidad de Santander (UDE), Bucaramanga, Colombia
| | - Jun Zhu
- Fu Wai Hospital, Beijing, China
| | - Matyas Keltai
- Gottsegen Gyorgy Hungarian Institute of Cardiology, Budapest, Hungary
| | - Anthony Dans
- Asia-Pacific Center for Evidence Based Medicine, Manilla, Philippines
| | | | | | - William Toff
- Department of Cardiovascular Sciences, University of Leicester, and NIHR Leicester, Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, United Kingdom
| | | | | | - Balakumar Swaminathan
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Michael Bohm
- Internal Medicine Clinic III, Saarland University Medical Center, Homburg/Saar, Germany
| | - Salim Yusuf
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
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Ezekowitz JA, Lewis BS, Lopes RD, Wojdyla DM, McMurray JJV, Hanna M, Atar D, Cecilia Bahit M, Keltai M, Lopez-Sendon JL, Pais P, Ruzyllo W, Wallentin L, Granger CB, Alexander JH. Clinical outcomes of patients with diabetes and atrial fibrillation treated with apixaban: results from the ARISTOTLE trial. Eur Heart J Cardiovasc Pharmacother 2018; 1:86-94. [PMID: 27533976 DOI: 10.1093/ehjcvp/pvu024] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 12/22/2014] [Indexed: 11/14/2022]
Abstract
AIMS We compared clinical outcomes in patients with AF with and without diabetes in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial. METHODS AND RESULTS The main efficacy endpoints were SSE and mortality; safety endpoints were major and major/clinically relevant non-major bleeding. A total of 4547/18 201 (24.9%) patients had diabetes who were younger (69 vs. 70 years), more had coronary artery disease (39 vs. 31%), and higher mean CHADS2 (2.9 vs. 1.9) and HAS-BLED scores (1.9 vs. 1.7) (all P < 0.0001) than patients without diabetes. Patients with diabetes receiving apixaban had lower rates of SSE [hazard ratio (HR) 0.75, 95% confidence interval (CI) 0.53-1.05), all-cause mortality (HR 0.83, 95% CI 0.67-1.02), cardiovascular mortality (HR 0.89, 95% CI 0.66-1.20), intra-cranial haemorrhage (HR 0.49, 95% CI 0.25-0.95), and a similar rate of myocardial infarction (HR 1.02, 95% CI 0.62-1.67) compared with warfarin. For major bleeding, a quantitative interaction was seen (P-interaction = 0.003) with a greater reduction in major bleeding in patients without diabetes even after multivariable adjustment. Other measures of bleeding showed a consistent reduction with apixaban compared with warfarin without a significant interaction based on diabetes status. CONCLUSION Apixaban has similar benefits on reducing stroke, decreasing mortality, and causing less intra-cranial bleeding than warfarin in patients with and without diabetes.
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Affiliation(s)
| | - Basil S Lewis
- Lady Davis Carmel Medical Center and the Ruth and Bruce Rappaport School of Medicine, Technion-IIT, Haifa, Israel
| | - Renato D Lopes
- Duke Clinical Research Institute, Duke Medicine, Durham, NC, USA
| | - Daniel M Wojdyla
- Duke Clinical Research Institute, Duke Medicine, Durham, NC, USA
| | | | | | - Dan Atar
- Oslo University Hospital, Oslo, Norway
| | | | - Matyas Keltai
- Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary
| | | | - Prem Pais
- St. John's Medical College, Bangalore, India
| | | | - Lars Wallentin
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | | | - John H Alexander
- Duke Clinical Research Institute, Duke Medicine, Durham, NC, USA
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Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, Probstfield J, Riddle MC, Rydén L, Xavier D, Atisso CM, Avezum A, Basile J, Chung N, Conget I, Cushman WC, Franek E, Hancu N, Hanefeld M, Holt S, Jansky P, Keltai M, Lanas F, Leiter LA, Lopez-Jaramillo P, Cardona-Munoz EG, Pirags V, Pogosova N, Raubenheimer PJ, Shaw J, Sheu WHH, Temelkova-Kurktschiev T. Design and baseline characteristics of participants in the Researching cardiovascular Events with a Weekly INcretin in Diabetes (REWIND) trial on the cardiovascular effects of dulaglutide. Diabetes Obes Metab 2018; 20:42-49. [PMID: 28573765 DOI: 10.1111/dom.13028] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 05/12/2017] [Accepted: 05/24/2017] [Indexed: 12/22/2022]
Abstract
The aim was to determine the effects of dulaglutide, a synthetic once-weekly, injectable human glucagon-like peptide 1 analogue that lowers blood glucose, body weight, appetite and blood pressure, on cardiovascular outcomes. People with type 2 diabetes, aged ≥50 years, with glycated haemoglobin (HbA1c) ≤9.5%, and either a previous cardiovascular event, evidence of cardiovascular disease or ≥2 cardiovascular risk factors were randomly allocated to a weekly subcutaneous injection of either dulaglutide (1.5 mg) or placebo and followed within the ongoing Researching cardiovascular Events with a Weekly INcretin in Diabetes (REWIND) trial every 3 to 6 months. The primary cardiovascular outcome is the first occurrence of the composite of cardiovascular death or non-fatal myocardial infarction or non-fatal stroke. Secondary outcomes include each component of the primary composite cardiovascular outcome, a composite clinical microvascular outcome comprising retinal or renal disease, hospitalization for unstable angina, heart failure requiring hospitalization or an urgent heart failure visit, and all-cause mortality. Follow-up will continue until the accrual of 1200 confirmed primary outcomes. Recruitment of 9901 participants (mean age 66 years, 46% women) occurred in 370 sites located in 24 countries over a period of 2 years. The mean duration of diabetes was 10 years, mean baseline HbA1c was 7.3%, and 31% had prior cardiovascular disease. The REWIND trial's international scope, high proportion of women, high proportion of people without prior cardiovascular disease and inclusion of participants whose mean baseline HbA1c was 7.3% suggests that its cardiovascular and safety findings will be directly relevant to the typical middle-aged patient seen in general practice throughout the world.
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Affiliation(s)
- Hertzel C Gerstein
- Department of Medicine and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
| | | | | | - Rafael Diaz
- ECLA Academic Research Organization and ICR Instituto Cardiovascular de Rosario, Rosario, Argentina
| | | | - Prem Pais
- St. John's Research Institute, Bangalore, India
| | | | - Matthew C Riddle
- Department of Medicine, Oregon Health & Science University Portland, Portland, Oregon
| | | | | | | | - Alvaro Avezum
- Instituto Dante Pazzanese de Cardiologia and University Santos Amaro, São Paulo, Brazil
| | - Jan Basile
- Medical University of South Carolina, Charleston, South Carolina
| | - Namsik Chung
- Yonsei University Health System, Seoul, South Korea
| | - Ignacio Conget
- Endocrinology and Nutrition Department, Hospital Clínic i Universitari, Barcelona, Spain
| | | | - Edward Franek
- Mossakowski Medical Research Centre, Polish Academy of Sciences and Central Clinical Hospital MSW, Warsaw, Poland
| | - Nicolae Hancu
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | | | - Shaun Holt
- Victoria University of Wellington, Wellington, New Zealand
| | - Petr Jansky
- University Hospital Motol, Prague, Czech Republic
| | - Matyas Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary
| | | | - Lawrence A Leiter
- Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Patricio Lopez-Jaramillo
- Research Institute, FOSCAL and Medical School, Universidad d Santander UDES, Bucaramanga, Colombia
| | - Ernesto G Cardona-Munoz
- Universidad de Guadalajara Centro Universitario de Ciencias de la Salud, Guadalajara, Mexico
| | | | - Nana Pogosova
- National Research Center for Preventive Medicine, Moscow, Russia
| | | | - Jonathan Shaw
- Baker Heart and Diabetes Institute, Melbourne, Australia
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Eikelboom JW, Connolly SJ, Bosch J, Dagenais GR, Hart RG, Shestakovska O, Diaz R, Alings M, Lonn EM, Anand SS, Widimsky P, Hori M, Avezum A, Piegas LS, Branch KRH, Probstfield J, Bhatt DL, Zhu J, Liang Y, Maggioni AP, Lopez-Jaramillo P, O'Donnell M, Kakkar AK, Fox KAA, Parkhomenko AN, Ertl G, Störk S, Keltai M, Ryden L, Pogosova N, Dans AL, Lanas F, Commerford PJ, Torp-Pedersen C, Guzik TJ, Verhamme PB, Vinereanu D, Kim JH, Tonkin AM, Lewis BS, Felix C, Yusoff K, Steg PG, Metsarinne KP, Cook Bruns N, Misselwitz F, Chen E, Leong D, Yusuf S. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med 2017; 377:1319-1330. [PMID: 28844192 DOI: 10.1056/nejmoa1709118] [Citation(s) in RCA: 1449] [Impact Index Per Article: 207.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. METHODS In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after a mean follow-up of 23 months. RESULTS The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86; P<0.001; z=-4.126), but major bleeding events occurred in more patients in the rivaroxaban-plus-aspirin group (288 patients [3.1%] vs. 170 patients [1.9%]; hazard ratio, 1.70; 95% CI, 1.40 to 2.05; P<0.001). There was no significant difference in intracranial or fatal bleeding between these two groups. There were 313 deaths (3.4%) in the rivaroxaban-plus-aspirin group as compared with 378 (4.1%) in the aspirin-alone group (hazard ratio, 0.82; 95% CI, 0.71 to 0.96; P=0.01; threshold P value for significance, 0.0025). The primary outcome did not occur in significantly fewer patients in the rivaroxaban-alone group than in the aspirin-alone group, but major bleeding events occurred in more patients in the rivaroxaban-alone group. CONCLUSIONS Among patients with stable atherosclerotic vascular disease, those assigned to rivaroxaban (2.5 mg twice daily) plus aspirin had better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban (5 mg twice daily) alone did not result in better cardiovascular outcomes than aspirin alone and resulted in more major bleeding events. (Funded by Bayer; COMPASS ClinicalTrials.gov number, NCT01776424 .).
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Affiliation(s)
- John W Eikelboom
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Stuart J Connolly
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Jackie Bosch
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Gilles R Dagenais
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Robert G Hart
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Olga Shestakovska
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Rafael Diaz
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Marco Alings
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Eva M Lonn
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Sonia S Anand
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Petr Widimsky
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Masatsugu Hori
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Alvaro Avezum
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Leopoldo S Piegas
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Kelley R H Branch
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Jeffrey Probstfield
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Deepak L Bhatt
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Jun Zhu
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Yan Liang
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Aldo P Maggioni
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Patricio Lopez-Jaramillo
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Martin O'Donnell
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Ajay K Kakkar
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Keith A A Fox
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Alexander N Parkhomenko
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Georg Ertl
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Stefan Störk
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Matyas Keltai
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Lars Ryden
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Nana Pogosova
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Antonio L Dans
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Fernando Lanas
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Patrick J Commerford
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Christian Torp-Pedersen
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Tomek J Guzik
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Peter B Verhamme
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Dragos Vinereanu
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Jae-Hyung Kim
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Andrew M Tonkin
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Basil S Lewis
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Camilo Felix
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Khalid Yusoff
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - P Gabriel Steg
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Kaj P Metsarinne
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Nancy Cook Bruns
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Frank Misselwitz
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Edmond Chen
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Darryl Leong
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
| | - Salim Yusuf
- From the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON (J.W.E., S.J.C., J.B., R.G.H., O.S., E.M.L., S.S.A., D.L., S.Y.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC (G.R.D.) - both in Canada; Estudios Clínicos Latino América and Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Amphia Ziekenhuis and Werkgroep Cardiologische Centra Nederland (WCN), Utrecht, the Netherlands (M.A.); Cardiocenter, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic (P.W.); Osaka International Cancer Institute, Osaka, Japan (M.H.); Instituto Dante Pazzanese de Cardiologia (A.A.), and Hospital do Coração (L.S.P.), São Paulo; University of Washington Medical Center (K.R.H.B.) and University of Washington (J.P.), Seattle; Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston (D.L.B.); FuWai Hospital, Beijing (J.Z., Y.L.); National Association of Hospital Cardiologists Research Center (ANMCO), Florence, Italy (A.P.M.); Research Institute, Fundación Oftalmológica de Santander (FOSCAL)-Bucaramanga, Bucaramanga, Colombia (P.L.-J.); National University of Ireland, Galway (M.O.); Thrombosis Research Institute and University College London, London (A.K.K.), Centre for Cardiovascular Science, University of Edinburgh, Edinburgh (K.A.A.F.), and University of Glasgow, Glasgow (T.J.G.) - all in the United Kingdom; Collegium Medicum Jagiellonian University, Krakow, Poland (T.J.G); Institute of Cardiology, Kiev, Ukraine (A.N.P.); University of Würzburg and University Hospital, Würzburg (G.E., S.S.), and Bayer, Leverkusen (N.C.B., F.M., E.C.) - all in Germany; Semmelweis University, Budapest, Hungary (M.K.); Karolinska Institutet, Stockholm (L.R.); National Research Center for Preventative Medicine, Moscow (N.P.); University of Philippines, Manila (A.L.D.); Universidad de La Frontera, Temuco, Chile (F.L.); University of Cape Town, Cape Town, South Africa (P.J.C.); University of Aalborg, Copenhagen (C.T.-P.); University of Leuven, Leuven, Belgium (P.B.V.); University of Medicine and Pharmacology, Carol Davila University and Emergency Hospital, Bucharest, Romania (D.V.); Catholic University of Korea, Seoul, South Korea (J.-H.K.); Monash University, Melbourne, VIC, Australia (A.M.T.); Lady Davis Carmel Medical Center, Haifa, Israel (B.S.L.); Facultad de Ciencias de la Salud Eugenio Espejo-Universidad Tecnológica Equinoccial, Quito, Ecuador (C.F.); Universiti Teknologi Mara, Selangor, Malaysia (K.Y.); Université Paris Diderot, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris (P.G.S.); and Turku University Central Hospital and Turku University, Turku, Finland (K.P.M.)
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Bosch J, Eikelboom JW, Connolly SJ, Bruns NC, Lanius V, Yuan F, Misselwitz F, Chen E, Diaz R, Alings M, Lonn EM, Widimsky P, Hori M, Avezum A, Piegas LS, Bhatt DL, Branch KR, Probstfield JL, Liang Y, Liu L, Zhu J, Maggioni AP, Lopez-Jaramillo P, O'Donnell M, Fox KA, Kakkar A, Parkhomenko AN, Ertl G, Störk S, Keltai K, Keltai M, Ryden L, Dagenais GR, Pogosova N, Dans AL, Lanas F, Commerford PJ, Torp-Pedersen C, Guzik TJ, Verhamme PB, Vinereanu D, Kim JH, Ha JW, Tonkin AM, Varigos JD, Lewis BS, Felix C, Yusoff K, Steg PG, Aboyans V, Metsarinne KP, Anand SS, Hart RG, Lamy A, Moayyedi P, Leong DP, Sharma M, Yusuf S. Rationale, Design and Baseline Characteristics of Participants in the C ardiovascular O utco m es for P eople Using A nticoagulation S trategie s (COMPASS) Trial. Can J Cardiol 2017; 33:1027-1035. [DOI: 10.1016/j.cjca.2017.06.001] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 06/04/2017] [Accepted: 06/04/2017] [Indexed: 12/22/2022] Open
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Mantovani L, Cozzolino P, Angiolella L, Agnelli G, Ambrosio G, Camm A, Darius H, Fitzmaurice D, Fox K, Kayani G, Keltai M, Le Heuzey JY, Pieper K, Kakkar A. P4603The burden of atrial fibrillation in the more populated European countries: perspectives from the GARFIELD-AF registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | | | - G. Ambrosio
- University of Perugia School of Medicine, Perugia, Italy
| | - A.J. Camm
- St George's University of London, London, United Kingdom
| | - H. Darius
- Vivantes Neukoelln Medical Centre, Berlin, Germany
| | | | - K.A.A. Fox
- University of Edinburgh, Edinburgh, United Kingdom
| | - G. Kayani
- Thrombosis Research Institute, London, United Kingdom
| | - M. Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary
| | - J.-Y. Le Heuzey
- Georges Pompidou Hospital, René Descartes University, Paris, France
| | - K.S. Pieper
- Duke Clinical Research Institute, Durham, United States of America
| | - A.K. Kakkar
- Thrombosis Research Institute and University College London, London, United Kingdom
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Westenbrink BD, Alings M, Granger CB, Alexander JH, Lopes RD, Hylek EM, Thomas L, Wojdyla DM, Hanna M, Keltai M, Steg PG, De Caterina R, Wallentin L, van Gilst WH. Anemia is associated with bleeding and mortality, but not stroke, in patients with atrial fibrillation: Insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial. Am Heart J 2017; 185:140-149. [PMID: 28267467 DOI: 10.1016/j.ahj.2016.12.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 12/16/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Patients with atrial fibrillation (AF) are prone to cardiovascular events and anticoagulation-related bleeding complications. We hypothesized that patients with anemia are at increased risk for these outcomes. METHODS We performed a post hoc analysis of the ARISTOTLE trial, which included >18,000 patients with AF randomized to warfarin (target international normalized ratio, 2.0-3.0) or apixaban 5 mg twice daily. Multivariable Cox regression analysis was used to determine if anemia (defined as hemoglobin <13.0 in men and <12.0 g/dL in women) was associated with future stroke, major bleeding, or mortality. RESULTS Anemia was present at baseline in 12.6% of the ARISTOTLE population. Patients with anemia were older, had higher mean CHADS2 and HAS-BLED scores, and were more likely to have experienced previous bleeding events. Anemia was associated with major bleeding (adjusted hazard ratio [HR], 1.92; 95% CI, 1.62-2.28; P<.0001) and all-cause mortality (adjusted HR, 1.68; 95% CI, 1.46-1.93; P<.0001) but not stroke or systemic embolism (adjusted HR, 0.92; 95% CI, 0.70-1.21). The benefits of apixaban compared with warfarin on the rates of stroke, mortality, and bleeding events were consistent in patients with and without anemia. CONCLUSIONS Chronic anemia is associated with a higher incidence of bleeding complications and mortality, but not of stroke, in anticoagulated patients with AF. Apixaban is an attractive anticoagulant for stroke prevention in patients with AF with or without anemia.
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Affiliation(s)
- B Daan Westenbrink
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
| | - Marco Alings
- Working Group on Cardiovascular Research, Utrecht, Netherlands
| | | | - John H Alexander
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Renato D Lopes
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | | | - Laine Thomas
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Daniel M Wojdyla
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | | | - Matyas Keltai
- Hungarian Institute of Cardiology, Budapest, Hungary
| | - P Gabriel Steg
- DHU FIRE, Université Paris-Diderot, Hôpital Bichat, AP-HP, INSERM, Paris, France
| | | | - Lars Wallentin
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Wiek H van Gilst
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Hijazi Z, Hohnloser SH, Andersson U, Alexander JH, Hanna M, Keltai M, Parkhomenko A, López-Sendón JL, Lopes RD, Siegbahn A, Granger CB, Wallentin L. Efficacy and Safety of Apixaban Compared With Warfarin in Patients With Atrial Fibrillation in Relation to Renal Function Over Time. JAMA Cardiol 2016; 1:451-60. [DOI: 10.1001/jamacardio.2016.1170] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Ziad Hijazi
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden2Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | | | - Ulrika Andersson
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - John H. Alexander
- Duke Clinical Research Institute, Duke Medicine, Durham, North Carolina
| | | | - Matyas Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary
| | | | | | - Renato D. Lopes
- Duke Clinical Research Institute, Duke Medicine, Durham, North Carolina
| | - Agneta Siegbahn
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden9Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | | | - Lars Wallentin
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden2Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
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Lonn EM, Bosch J, López-Jaramillo P, Zhu J, Liu L, Pais P, Diaz R, Xavier D, Sliwa K, Dans A, Avezum A, Piegas LS, Keltai K, Keltai M, Chazova I, Peters RJG, Held C, Yusoff K, Lewis BS, Jansky P, Parkhomenko A, Khunti K, Toff WD, Reid CM, Varigos J, Leiter LA, Molina DI, McKelvie R, Pogue J, Wilkinson J, Jung H, Dagenais G, Yusuf S. Blood-Pressure Lowering in Intermediate-Risk Persons without Cardiovascular Disease. N Engl J Med 2016; 374:2009-20. [PMID: 27041480 DOI: 10.1056/nejmoa1600175] [Citation(s) in RCA: 422] [Impact Index Per Article: 52.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Antihypertensive therapy reduces the risk of cardiovascular events among high-risk persons and among those with a systolic blood pressure of 160 mm Hg or higher, but its role in persons at intermediate risk and with lower blood pressure is unclear. METHODS In one comparison from a 2-by-2 factorial trial, we randomly assigned 12,705 participants at intermediate risk who did not have cardiovascular disease to receive either candesartan at a dose of 16 mg per day plus hydrochlorothiazide at a dose of 12.5 mg per day or placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke; the second coprimary outcome additionally included resuscitated cardiac arrest, heart failure, and revascularization. The median follow-up was 5.6 years. RESULTS The mean blood pressure of the participants at baseline was 138.1/81.9 mm Hg; the decrease in blood pressure was 6.0/3.0 mm Hg greater in the active-treatment group than in the placebo group. The first coprimary outcome occurred in 260 participants (4.1%) in the active-treatment group and in 279 (4.4%) in the placebo group (hazard ratio, 0.93; 95% confidence interval [CI], 0.79 to 1.10; P=0.40); the second coprimary outcome occurred in 312 participants (4.9%) and 328 participants (5.2%), respectively (hazard ratio, 0.95; 95% CI, 0.81 to 1.11; P=0.51). In one of the three prespecified hypothesis-based subgroups, participants in the subgroup for the upper third of systolic blood pressure (>143.5 mm Hg) who were in the active-treatment group had significantly lower rates of the first and second coprimary outcomes than those in the placebo group; effects were neutral in the middle and lower thirds (P=0.02 and P=0.009, respectively, for trend in the two outcomes). CONCLUSIONS Therapy with candesartan at a dose of 16 mg per day plus hydrochlorothiazide at a dose of 12.5 mg per day was not associated with a lower rate of major cardiovascular events than placebo among persons at intermediate risk who did not have cardiovascular disease. (Funded by the Canadian Institutes of Health Research and AstraZeneca; ClinicalTrials.gov number, NCT00468923.).
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Affiliation(s)
- Eva M Lonn
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Jackie Bosch
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Patricio López-Jaramillo
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Jun Zhu
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Lisheng Liu
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Prem Pais
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Rafael Diaz
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Denis Xavier
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Karen Sliwa
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Antonio Dans
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Alvaro Avezum
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Leopoldo S Piegas
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Katalin Keltai
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Matyas Keltai
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Irina Chazova
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Ron J G Peters
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Claes Held
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Khalid Yusoff
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Basil S Lewis
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Petr Jansky
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Alexander Parkhomenko
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Kamlesh Khunti
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - William D Toff
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Christopher M Reid
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - John Varigos
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Lawrence A Leiter
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Dora I Molina
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Robert McKelvie
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Janice Pogue
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Joanne Wilkinson
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Hyejung Jung
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Gilles Dagenais
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
| | - Salim Yusuf
- From the Population Health Research Institute, Hamilton Health Sciences (E.M.L., J.B., R.M., J.P., J.W., H.J., S.Y.), the Department of Medicine (E.M.L., R.M., S.Y.), the School of Rehabilitation Science (J.B.), and the Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Caldas and Institución Prestadora de Salud Internistas de Caldas, Manizales (D.I.M.S.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Research Institute (P.P., D.X.) and St. John's Medical College (D.X.), Bangalore, India; Instituto Cardiovascular de Rosario, Rosario, Argentina (R.D.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.) - both in São Paulo; Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (K. Keltai, M.K.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Ca
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Yusuf S, Lonn E, Pais P, Bosch J, López-Jaramillo P, Zhu J, Xavier D, Avezum A, Leiter LA, Piegas LS, Parkhomenko A, Keltai M, Keltai K, Sliwa K, Chazova I, Peters RJG, Held C, Yusoff K, Lewis BS, Jansky P, Khunti K, Toff WD, Reid CM, Varigos J, Accini JL, McKelvie R, Pogue J, Jung H, Liu L, Diaz R, Dans A, Dagenais G. Blood-Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease. N Engl J Med 2016; 374:2032-43. [PMID: 27039945 DOI: 10.1056/nejmoa1600177] [Citation(s) in RCA: 237] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Elevated blood pressure and elevated low-density lipoprotein (LDL) cholesterol increase the risk of cardiovascular disease. Lowering both should reduce the risk of cardiovascular events substantially. METHODS In a trial with 2-by-2 factorial design, we randomly assigned 12,705 participants at intermediate risk who did not have cardiovascular disease to rosuvastatin (10 mg per day) or placebo and to candesartan (16 mg per day) plus hydrochlorothiazide (12.5 mg per day) or placebo. In the analyses reported here, we compared the 3180 participants assigned to combined therapy (with rosuvastatin and the two antihypertensive agents) with the 3168 participants assigned to dual placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, and the second coprimary outcome additionally included heart failure, cardiac arrest, or revascularization. The median follow-up was 5.6 years. RESULTS The decrease in the LDL cholesterol level was 33.7 mg per deciliter (0.87 mmol per liter) greater in the combined-therapy group than in the dual-placebo group, and the decrease in systolic blood pressure was 6.2 mm Hg greater with combined therapy than with dual placebo. The first coprimary outcome occurred in 113 participants (3.6%) in the combined-therapy group and in 157 (5.0%) in the dual-placebo group (hazard ratio, 0.71; 95% confidence interval [CI], 0.56 to 0.90; P=0.005). The second coprimary outcome occurred in 136 participants (4.3%) and 187 participants (5.9%), respectively (hazard ratio, 0.72; 95% CI, 0.57 to 0.89; P=0.003). Muscle weakness and dizziness were more common in the combined-therapy group than in the dual-placebo group, but the overall rate of discontinuation of the trial regimen was similar in the two groups. CONCLUSIONS The combination of rosuvastatin (10 mg per day), candesartan (16 mg per day), and hydrochlorothiazide (12.5 mg per day) was associated with a significantly lower rate of cardiovascular events than dual placebo among persons at intermediate risk who did not have cardiovascular disease. (Funded by the Canadian Institutes of Health Research and AstraZeneca; ClinicalTrials.gov number, NCT00468923.).
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Affiliation(s)
- Salim Yusuf
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Eva Lonn
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Prem Pais
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Jackie Bosch
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Patricio López-Jaramillo
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Jun Zhu
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Denis Xavier
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Alvaro Avezum
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Lawrence A Leiter
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Leopoldo S Piegas
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Alexander Parkhomenko
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Matyas Keltai
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Katalin Keltai
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Karen Sliwa
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Irina Chazova
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Ron J G Peters
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Claes Held
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Khalid Yusoff
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Basil S Lewis
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Petr Jansky
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Kamlesh Khunti
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - William D Toff
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Christopher M Reid
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - John Varigos
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Jose L Accini
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Robert McKelvie
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Janice Pogue
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Hyejung Jung
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Lisheng Liu
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Rafael Diaz
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Antonio Dans
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
| | - Gilles Dagenais
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., E.L., J.B., R.M., J.P., H.J.), Department of Medicine (S.Y., E.L., R.M.), School of Rehabilitation Science (J.B.), Department of Clinical Epidemiology and Biostatistics (J.P.), McMaster University, Hamilton, ON, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.), and Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.) - all in Canada; St. John's Research Institute (P.P., D.X.), and St. John's Medical College (D.X.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and Universidad del Norte, Barranquilla (J.L.A.) - both in Colombia; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), Sao Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K., K. Keltai); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); the Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P.); the Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur (K.Y.) - both in Malaysia; Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (B.S.L.); University Hospital Motol, Prague, Czech Repu
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Yusuf S, Bosch J, Dagenais G, Zhu J, Xavier D, Liu L, Pais P, López-Jaramillo P, Leiter LA, Dans A, Avezum A, Piegas LS, Parkhomenko A, Keltai K, Keltai M, Sliwa K, Peters RJG, Held C, Chazova I, Yusoff K, Lewis BS, Jansky P, Khunti K, Toff WD, Reid CM, Varigos J, Sanchez-Vallejo G, McKelvie R, Pogue J, Jung H, Gao P, Diaz R, Lonn E. Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease. N Engl J Med 2016; 374:2021-31. [PMID: 27040132 DOI: 10.1056/nejmoa1600176] [Citation(s) in RCA: 536] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous trials have shown that the use of statins to lower cholesterol reduces the risk of cardiovascular events among persons without cardiovascular disease. Those trials have involved persons with elevated lipid levels or inflammatory markers and involved mainly white persons. It is unclear whether the benefits of statins can be extended to an intermediate-risk, ethnically diverse population without cardiovascular disease. METHODS In one comparison from a 2-by-2 factorial trial, we randomly assigned 12,705 participants in 21 countries who did not have cardiovascular disease and were at intermediate risk to receive rosuvastatin at a dose of 10 mg per day or placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, and the second coprimary outcome additionally included revascularization, heart failure, and resuscitated cardiac arrest. The median follow-up was 5.6 years. RESULTS The overall mean low-density lipoprotein cholesterol level was 26.5% lower in the rosuvastatin group than in the placebo group. The first coprimary outcome occurred in 235 participants (3.7%) in the rosuvastatin group and in 304 participants (4.8%) in the placebo group (hazard ratio, 0.76; 95% confidence interval [CI], 0.64 to 0.91; P=0.002). The results for the second coprimary outcome were consistent with the results for the first (occurring in 277 participants [4.4%] in the rosuvastatin group and in 363 participants [5.7%] in the placebo group; hazard ratio, 0.75; 95% CI, 0.64 to 0.88; P<0.001). The results were also consistent in subgroups defined according to cardiovascular risk at baseline, lipid level, C-reactive protein level, blood pressure, and race or ethnic group. In the rosuvastatin group, there was no excess of diabetes or cancers, but there was an excess of cataract surgery (in 3.8% of the participants, vs. 3.1% in the placebo group; P=0.02) and muscle symptoms (in 5.8% of the participants, vs. 4.7% in the placebo group; P=0.005). CONCLUSIONS Treatment with rosuvastatin at a dose of 10 mg per day resulted in a significantly lower risk of cardiovascular events than placebo in an intermediate-risk, ethnically diverse population without cardiovascular disease. (Funded by the Canadian Institutes of Health Research and AstraZeneca; HOPE-3 ClinicalTrials.gov number, NCT00468923.).
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Affiliation(s)
- Salim Yusuf
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Jackie Bosch
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Gilles Dagenais
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Jun Zhu
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Denis Xavier
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Lisheng Liu
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Prem Pais
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Patricio López-Jaramillo
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Lawrence A Leiter
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Antonio Dans
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Alvaro Avezum
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Leopoldo S Piegas
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Alexander Parkhomenko
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Katalin Keltai
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Matyas Keltai
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Karen Sliwa
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Ron J G Peters
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Claes Held
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Irina Chazova
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Khalid Yusoff
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Basil S Lewis
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Petr Jansky
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Kamlesh Khunti
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - William D Toff
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Christopher M Reid
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - John Varigos
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Gregorio Sanchez-Vallejo
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Robert McKelvie
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Janice Pogue
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Hyejung Jung
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Peggy Gao
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Rafael Diaz
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
| | - Eva Lonn
- From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
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Andell P, James SK, Cannon CP, Cyr DD, Himmelmann A, Husted S, Keltai M, Koul S, Santoso A, Steg PG, Storey RF, Wallentin L, Erlinge D. Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes and Chronic Obstructive Pulmonary Disease: An Analysis From the Platelet Inhibition and Patient Outcomes (PLATO) Trial. J Am Heart Assoc 2015; 4:e002490. [PMID: 26452988 PMCID: PMC4845124 DOI: 10.1161/jaha.115.002490] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) experiencing acute coronary syndromes (ACS) are at high risk for clinical events. In the Platelet Inhibition and Patient Outcomes (PLATO) trial, ticagrelor versus clopidogrel reduced the primary endpoint of death from vascular causes, myocardial infarction, or stroke after ACS, but increased the incidence of dyspnea, which may lead clinicians to withhold ticagrelor from COPD patients. METHODS AND RESULTS In 18 624 patients with ACS randomized to treatment with ticagrelor or clopidogrel, history of COPD was recorded in 1085 (5.8%). At 1 year, the primary endpoint occurred in 17.7% of patients with COPD versus 10.4% in those without COPD (P<0.001). The 1-year event rate for the primary endpoint in COPD patients treated with ticagrelor versus clopidogrel was 14.8% versus 20.6% (hazard ratio [HR]=0.72; 95% confidence interval [CI]: 0.54 to 0.97), for death from any cause 8.4% versus 12.4% (HR=0.70; 95% CI: 0.47 to 1.04), and for PLATO-defined major bleeding rates at 1 year 14.6% versus 16.6% (HR=0.85; 95% CI: 0.61 to 1.17). Dyspnea occurred more frequently with ticagrelor (26.1% vs. 16.3%; HR=1.71; 95% CI: 1.28 to 2.30). There was no differential increase in the relative risk of dyspnea compared to non-COPD patients (HR=1.85). No COPD status-by-treatment interactions were found, showing consistency with the main trial results. CONCLUSIONS In this post-hoc analysis, COPD patients experienced high rates of ischemic events. Ticagrelor versus clopidogrel reduced and substantially decreased the absolute risk of ischemic events (5.8%) in COPD patients, without increasing overall major bleeding events. The benefit-risk profile supports the use of ticagrelor in patients with ACS and concomitant COPD. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00391872.
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Affiliation(s)
- Pontus Andell
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden (P.A., S.K., D.E.)
| | - Stefan K James
- Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J., L.W.)
| | - Christopher P Cannon
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (C.P.C.) Harvard Clinical Research Institute, Boston, MA (C.P.C.)
| | - Derek D Cyr
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (D.D.C.)
| | | | - Steen Husted
- Medical Department, Hospital Unit West, Herning/Holstebro, Denmark (S.H.)
| | - Matyas Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary (M.K.)
| | - Sasha Koul
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden (P.A., S.K., D.E.)
| | - Anwar Santoso
- Department of Cardiology, Vascular Medicine, Faculty of Medicine, Harapan Kita Hospital, National Cardiovascular Center, University of Indonesia, Jakarta, Indonesia (A.S.)
| | - Ph Gabriel Steg
- INSERM-Unité 1148, Paris, France (P.G.S.) Département Hospitalo-Universitaire FIRE, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Paris, France (P.G.S.) Sorbonne-Paris Cité, Université Paris-Diderot, Paris, France (P.G.S.) NHLI Imperial College, ICMS, Royal Brompton Hospital, London, UK (P.G.S.)
| | - Robert F Storey
- Department of Cardiovascular Science, University of Sheffield Sheffield, UK (R.F.S.)
| | - Lars Wallentin
- Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J., L.W.)
| | - David Erlinge
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden (P.A., S.K., D.E.)
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Lonn E, Bosch J, Pogue J, Avezum A, Chazova I, Dans A, Diaz R, Fodor GJ, Held C, Jansky P, Keltai M, Keltai K, Kunti K, Kim JH, Leiter L, Lewis B, Liu L, Lopez-Jaramillo P, Pais P, Parkhomenko A, Peters RJG, Piegas LS, Reid CM, Sliwa K, Toff WD, Varigos J, Xavier D, Yusoff K, Zhu J, Dagenais G, Yusuf S. Novel Approaches in Primary Cardiovascular Disease Prevention: The HOPE-3 Trial Rationale, Design, and Participants' Baseline Characteristics. Can J Cardiol 2015; 32:311-8. [PMID: 26481083 DOI: 10.1016/j.cjca.2015.07.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 07/01/2015] [Accepted: 07/01/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cholesterol and blood pressure (BP) can be effectively and safely lowered with statin drugs and BP-lowering drugs, reducing major cardiovascular (CV) events by 20%-30% within 5 years in high-risk individuals. However, there are limited data in lower-risk populations. The Heart Outcomes Prevention Evaluation-3 (HOPE-3) trial is evaluating whether cholesterol lowering with a statin drug, BP lowering with low doses of 2 antihypertensive agents, and their combination safely reduce major CV events in individuals at intermediate risk who have had no previous vascular events and have average cholesterol and BP levels. METHODS A total of 12,705 women 65 years or older and men 55 years or older with at least 1 CV risk factor, no known CV disease, and without any clear indication or contraindication to the study drugs were randomized to rosuvastatin 10 mg/d or placebo and to candesartan/hydrochlorothiazide 16/12.5 mg/d or placebo (2 × 2 factorial design) and will be followed for a mean of 5.8 years. The coprimary study outcomes are the composite of CV death, nonfatal myocardial infarction (MI), and nonfatal stroke and the composite of CV death, nonfatal MI, nonfatal stroke, resuscitated cardiac arrest, heart failure, and arterial revascularization. RESULTS Participants were recruited from 21 countries in North America, South America, Europe, Asia, and Australia. Mean age at randomization was 66 years and 46% were women. CONCLUSIONS The HOPE-3 trial will provide new information on cholesterol and BP lowering in intermediate-risk populations with average cholesterol and BP levels and is expected to inform approaches to primary prevention worldwide (HOPE-3 ClinicalTrials.gov NCT00468923).
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Affiliation(s)
- Eva Lonn
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.
| | - Jackie Bosch
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Janice Pogue
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Alvaro Avezum
- Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - Irina Chazova
- Russian Cardiology Research Complex, Moscow, Russian Federation
| | - Antonio Dans
- College of Medicine of the University of the Philippines, Manula, Philippines
| | | | - George J Fodor
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Claes Held
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Petr Jansky
- University Hospital Motol, Prague, Czech Republic
| | - Matyas Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary
| | - Katalin Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary
| | - Kamlesh Kunti
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Jae-Hyung Kim
- St. Paul's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Lawrence Leiter
- Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Basil Lewis
- Lady Davis Carmel Medical Center and the Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Lisheng Liu
- Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Patricio Lopez-Jaramillo
- Fundacion Oftalmolgica de Santander (FOSCAL) and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga, Colombia
| | - Prem Pais
- Division of Clinical Research and Training, St. John's Research Institute, Bangalore, India
| | | | - Ron J G Peters
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Christopher M Reid
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Karen Sliwa
- Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town and Soweto Cardiovascular Research Group, University of the Witwatersrand, Johannesburg, South Africa
| | - William D Toff
- Department of Cardiovascular Sciences, University of Leicester and Leicester NIHR Biomedical Research Unit in Cardiovascular Disease, Glenfield Hospital, Leicester, United Kingdom
| | - John Varigos
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Denis Xavier
- Division of Clinical Research and Training, St. John's Research Institute, Bangalore, India
| | | | - Jun Zhu
- Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gilles Dagenais
- Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Québec, Canada
| | - Salim Yusuf
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
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Denardo SJ, Gong Y, Cooper-DeHoff RM, Farsang C, Keltai M, Szirmai L, Messerli FH, Bavry AA, Handberg EM, Mancia G, Pepine CJ. Effects of verapamil SR and atenolol on 24-hour blood pressure and heart rate in hypertension patients with coronary artery disease: an international verapamil SR-trandolapril ambulatory monitoring substudy. PLoS One 2015; 10:e0122726. [PMID: 25835002 PMCID: PMC4383326 DOI: 10.1371/journal.pone.0122726] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 02/05/2015] [Indexed: 11/23/2022] Open
Abstract
Elevated nighttime blood pressure (BP) and heart rate (HR), increased BP and HR variability, and altered diurnal variations of BP and HR (nighttime dipping and morning surge) in patients with systemic hypertension are each associated with increased adverse cardiovascular events. However, there are no reports on the effect of hypertension treatment on these important hemodynamic parameters in the growing population of hypertensive patients with atherosclerotic coronary artery disease (CAD). This was a pre-specified subgroup analysis of the INternational VErapamil SR-Trandolapril STudy (INVEST), which involved 22,576 clinically stable patients aged ≥50 years with hypertension and CAD randomized to either verapamil SR- or atenolol-based hypertension treatment strategies. The subgroup consisted of 117 patients undergoing 24-hour ambulatory monitoring at baseline and after 1 year of treatment. Hourly systolic and diastolic BP (SBP and DBP) decreased after 1 year for both verapamil SR- and atenolol-based treatment strategies compared with baseline (P<0.0001). Atenolol also decreased hourly HR (P<0.0001). Both treatment strategies decreased SBP variability (weighted standard deviation: P = 0.012 and 0.021, respectively). Compared with verapamil SR, atenolol also increased the prevalence of BP and HR nighttime dipping among prior non-dippers (BP: OR = 3.37; 95% CI: 1.26 – 8.97; P = 0.015; HR: OR = 4.06; 95% CI: 1.35-12.17; P = 0.012) and blunted HR morning surge (+2.8 vs. +4.5 beats/min/hr; P = 0.019). Both verapamil SR- and especially atenolol-based strategies resulted in favorable changes in ambulatory monitoring parameters that have been previously associated with increased adverse cardiovascular events.
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Affiliation(s)
- Scott J. Denardo
- Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Yan Gong
- Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, Florida, United States of America
| | - Rhonda M. Cooper-DeHoff
- Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida, United States of America
| | - Csaba Farsang
- St Imre Teaching Hospital Cardiometabolic Centre, Budapest, Hungary
| | - Matyas Keltai
- Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary
| | - László Szirmai
- N&Sz StudyMaster Medical Research Center Ltd., Szentendre, Hungary
| | - Franz H. Messerli
- Division of Cardiology, St Luke’s-Roosevelt Hospital Center and Columbia University, College of Medicine and Physicians, New York, New York, United States of America
| | - Anthony A. Bavry
- Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
- North Florida/South Georgia Veterans Affairs Health System, Gainesville, Florida, United States of America
| | - Eileen M. Handberg
- Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Giuseppe Mancia
- Clinica Medica, Ospedale San Gerardo dei Tintori Monza, University of Milano-Bicocca, Milan, Italy
| | - Carl J. Pepine
- Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
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40
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Andell P, James S, Cannon C, Cyr D, Himmelmann A, Husted S, Keltai M, Koul S, Santoso A, Steg P, Storey R, Wallentin L, Erlinge D. TICAGRELOR VERSUS CLOPIDOGREL IN PATIENTS WITH ACUTE CORONARY SYNDROMES AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE: AN ANALYSIS FROM THE PLATELET INHIBITION AND PATIENT OUTCOMES (PLATO) TRIAL. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)60114-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Flaker G, Lopes RD, Hylek E, Wojdyla DM, Thomas L, Al-Khatib SM, Sullivan RM, Hohnloser SH, Garcia D, Hanna M, Amerena J, Harjola VP, Dorian P, Avezum A, Keltai M, Wallentin L, Granger CB. Amiodarone, anticoagulation, and clinical events in patients with atrial fibrillation: insights from the ARISTOTLE trial. J Am Coll Cardiol 2014; 64:1541-50. [PMID: 25301455 DOI: 10.1016/j.jacc.2014.07.967] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 06/17/2014] [Accepted: 07/08/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Amiodarone is an effective medication in preventing atrial fibrillation (AF), but it interferes with the metabolism of warfarin. OBJECTIVES This study sought to examine the association of major thrombotic clinical events and bleeding with the use of amiodarone in the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial. METHODS Baseline characteristics of patients who received amiodarone at randomization were compared with those who did not receive amiodarone. The interaction between randomized treatment and amiodarone was tested using a Cox model, with main effects for randomized treatment and amiodarone and their interaction. Matching on the basis of a propensity score was used to compare patients who received and who did not receive amiodarone at the time of randomization. RESULTS In ARISTOTLE, 2,051 (11.4%) patients received amiodarone at randomization. Patients on warfarin and amiodarone had time in the therapeutic range that was lower than patients not on amiodarone (56.5% vs. 63.0%; p < 0.0001). More amiodarone-treated patients had a stroke or a systemic embolism (1.58%/year vs. 1.19%/year; adjusted hazard ratio [HR]: 1.47, 95% confidence interval [CI]: 1.03 to 2.10; p = 0.0322). Overall mortality and major bleeding rates were elevated, but were not significantly different in amiodarone-treated patients and patients not on amiodarone. When comparing apixaban with warfarin, patients who received amiodarone had a stroke or a systemic embolism rate of 1.24%/year versus 1.85%/year (HR: 0.68, 95% CI: 0.40 to 1.15), death of 4.15%/year versus 5.65%/year (HR: 0.74, 95% CI: 0.55 to 0.98), and major bleeding of 1.86%/year versus 3.06%/year (HR: 0.61, 95% CI: 0.39 to 0.96). In patients who did not receive amiodarone, the stroke or systemic embolism rate was 1.29%/year versus 1.57%/year (HR: 0.82, 95% CI: 0.68 to 1.00), death was 3.43%/year versus 3.68%/year (HR: 0.93, 95% CI: 0.83 to 1.05), and major bleeding was 2.18%/year versus 3.03%/year (HR: 0.72, 95% CI: 0.62 to 0.84). The interaction p values for amiodarone use by apixaban treatment effects were not significant. CONCLUSIONS Amiodarone use was associated with significantly increased stroke and systemic embolism risk and a lower time in the therapeutic range when used with warfarin. Apixaban consistently reduced the rate of stroke and systemic embolism, death, and major bleeding compared with warfarin in amiodarone-treated patients and patients who were not on amiodarone.
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Affiliation(s)
| | - Renato D Lopes
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Elaine Hylek
- Boston University Medical Center, Boston, Massachusetts
| | - Daniel M Wojdyla
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Laine Thomas
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Sana M Al-Khatib
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | | | | | - David Garcia
- Division of Hematology, University of Washington, Seattle, Washington
| | | | - John Amerena
- Geelong Cardiology Research Center, Deakin University, Victoria, Australia
| | - Veli-Pekka Harjola
- Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - Paul Dorian
- St. Michael's Hospital, Toronto, Ontario, Canada
| | - Alvaro Avezum
- Danta Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - Matyas Keltai
- Hungarian Institute of Cardiology, Semmelweis University, Budapest, Hungary
| | - Lars Wallentin
- Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Christopher B Granger
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
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Ezekowitz JA, Lewis B, Lopes R, Wojdyla D, McMurray J, Hanna M, Atar D, Bahit M, Keltai M, Lopez-Sendon J, Pais P, Ruzyllo W, Wallentin L, Alexander J. APIXABAN COMPARED WITH WARFARIN IN PATIENTS WITH DIABETES AND NONVALVULAR ATRIAL FIBRILLATION IN THE ARISTOTLE TRIAL. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60372-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bonaca MP, Murphy SA, Miller D, Herrman JPR, Gottlieb S, Keltai M, Menozzi A, Nicolau JC, Widimsky P, Antman EM, Wiviott SD. Patterns of long-term thienopyridine therapy and outcomes in patients with acute coronary syndrome treated with coronary stenting: Observations from the TIMI-38 Coronary Stent Registry. Clin Cardiol 2014; 37:293-9. [PMID: 24532082 DOI: 10.1002/clc.22247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 12/15/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The optimal duration of dual antiplatelet therapy (DAPT) after acute coronary syndrome (ACS) is not known. Factors influencing DAPT duration are not well described. HYPOTHESIS We hypothesized that continued DAPT 12 months beyond ACS would be associated with patient factors such as stent type and that it may be associated with lower rates of ischemic events. METHODS The TIMI 38 Coronary Stent Registry (CSR) followed patients who completed the TRITON-TIMI 38 trial, received a stent, and were alive and event free. Continuation of DAPT was determined by the treating physician. RESULTS The CSR enrolled 2110 patients (1679>12 months from index ACS) and followed for a median of 2.1 additional years. DAPT was continued in 554 (26%) and was more likely to be continued in patients with drug-eluting stents (DES; 54%) and in North America. The rate of cardiovascular death, MI, or stroke was 2.35% per year, and 13 patients (0.6%) experienced Academic Research Consortium definite or probable ST. Recurrent ischemic events were similar between patients who continued thienopyridine therapy and those who stopped at registry entry (P = 0.74 for cardiovascular death/MI/stroke; P = 0.72 for definite or probable ST). After propensity score adjustment, there was no significant difference in cardiovascular death/MI/stroke (P = 0.55) or bleeding (P = 0.51) with prolonged DAPT. CONCLUSIONS Patients stabilized for a year after ACS and stenting have low rates of ST relative to overall cardiovascular events. The decision to continue DAPT maybe associated with stent type (DES vs bare-metal stent) and region.
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Affiliation(s)
- Marc P Bonaca
- TIMI Study Group, Brigham and Women's Hospital, Boston, Massachusetts
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Wallentin L, Lopes RD, Hanna M, Thomas L, Hellkamp A, Nepal S, Hylek EM, Al-Khatib SM, Alexander JH, Alings M, Amerena J, Ansell J, Aylward P, Bartunek J, Commerford P, De Caterina R, Erol C, Harjola VP, Held C, Horowitz J, Huber K, Husted S, Keltai M, Lanas F, Lisheng L, McMurray JJV, Oh BH, Rosenqvist M, Ruzyllo W, Steg PG, Vinereanu D, Xavier D, Granger CB. Response to letter regarding article, "Efficacy and safety of apixaban compared with warfarin at different levels of predicted international normalized ratio control for stroke prevention in atrial fibrillation". Circulation 2014; 129:e21-2. [PMID: 24421367 DOI: 10.1161/circulationaha.113.005709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lars Wallentin
- Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
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Bordeleau L, Yakubovich N, Dagenais GR, Rosenstock J, Probstfield J, Chang Yu P, Ryden LE, Pirags V, Spinas GA, Birkeland KI, Ratner RE, Marin-Neto JA, Keltai M, Riddle MC, Bosch J, Yusuf S, Gerstein HC. The association of basal insulin glargine and/or n-3 fatty acids with incident cancers in patients with dysglycemia. Diabetes Care 2014; 37:1360-6. [PMID: 24574355 DOI: 10.2337/dc13-1468] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Epidemiologic studies linking insulin glargine and glucose-lowering therapies to cancers and n-3 fatty acids to cancer prevention have not been confirmed. We aimed to assess the effect of insulin glargine and n-3 fatty acids on incident cancers within the context of the ORIGIN (Outcome Reduction with Initial Glargine Intervention) trial. RESEARCH DESIGN AND METHODS The ORIGIN trial is an international, long-term, randomized two-by-two factorial study comparing insulin glargine with standard care and n-3 fatty acids with placebo (double blind) in people with dysglycemia at high risk for cardiovascular events. The primary outcome measure (cancer substudy) was the occurrence of any new or recurrent adjudicated cancer. Cancer mortality and cancer subtypes were also analyzed. RESULTS Among 12,537 people (mean age 63.5 years, SD 7.8; 4,388 females), 953 developed a cancer event during the median follow-up of 6.2 years. In the glargine and standard care groups, the incidence of cancers was 1.32 and 1.32 per 100 person-years, respectively (P = 0.97), and in the n-3 fatty acid and placebo groups, it was 1.28 and 1.36 per 100 person-years, respectively (P = 0.39). No difference in the effect of either intervention was noted within predefined subgroups (P for all interactions ≥0.17). Cancer-related mortality and cancer-specific outcomes also did not differ between groups. Postrandomization HbA1c levels, glucose-lowering therapies (including metformin), and BMI did not affect cancer outcomes. CONCLUSIONS Insulin glargine and n-3 fatty acids have a neutral association with overall and cancer-specific outcomes, including cancer-specific mortality. Exposure to glucose-lowering therapies, including metformin, and HbA1c level during the study did not alter cancer risk.
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Connolly SJ, Wallentin L, Ezekowitz MD, Eikelboom J, Oldgren J, Reilly PA, Brueckmann M, Pogue J, Alings M, Amerena JV, Avezum A, Baumgartner I, Budaj AJ, Chen JH, Dans AL, Darius H, Di Pasquale G, Ferreira J, Flaker GC, Flather MD, Franzosi MG, Golitsyn SP, Halon DA, Heidbuchel H, Hohnloser SH, Huber K, Jansky P, Kamensky G, Keltai M, Kim SS, Lau CP, Le Heuzey JY, Lewis BS, Liu L, Nanas J, Omar R, Pais P, Pedersen KE, Piegas LS, Raev D, Smith PJ, Talajic M, Tan RS, Tanomsup S, Toivonen L, Vinereanu D, Xavier D, Zhu J, Wang SQ, Duffy CO, Themeles E, Yusuf S. The Long-Term Multicenter Observational Study of Dabigatran Treatment in Patients With Atrial Fibrillation (RELY-ABLE) Study. Circulation 2013; 128:237-43. [PMID: 23770747 DOI: 10.1161/circulationaha.112.001139] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND During follow-up of between 1 and 3 years in the Randomized Evaluation of Long-term Anticoagulation Therapy (RE-LY) trial, 2 doses of dabigatran etexilate were shown to be effective and safe for the prevention of stroke or systemic embolism in patients with atrial fibrillation. There is a need for longer-term follow-up of patients on dabigatran and for further data comparing the 2 dabigatran doses. METHODS AND RESULTS Patients randomly assigned to dabigatran in RE-LY were eligible for the Long-term Multicenter Extension of Dabigatran Treatment in Patients with Atrial Fibrillation (RELY-ABLE) trial if they had not permanently discontinued study medication at the time of their final RE-LY study visit. Enrolled patients continued to receive the double-blind dabigatran dose received in RE-LY, for up to 28 months of follow up after RE-LY (median follow-up, 2.3 years). There were 5851 patients enrolled, representing 48% of patients originally randomly assigned to receive dabigatran in RE-LY and 86% of RELY-ABLE-eligible patients. Rates of stroke or systemic embolism were 1.46% and 1.60%/y on dabigatran 150 and 110 mg twice daily, respectively (hazard ratio, 0.91; 95% confidence interval, 0.69-1.20). Rates of major hemorrhage were 3.74% and 2.99%/y on dabigatran 150 and 110 mg (hazard ratio, 1.26; 95% confidence interval, 1.04-1.53). Rates of death were 3.02% and 3.10%/y (hazard ratio, 0.97; 95% confidence interval, 0.80-1.19). Rates of hemorrhagic stroke were 0.13% and 0.14%/y. CONCLUSIONS During 2.3 years of continued treatment with dabigatran after RE-LY, there was a higher rate of major bleeding with dabigatran 150 mg twice daily in comparison with 110 mg, and similar rates of stroke and death.
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Affiliation(s)
- Stuart J Connolly
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton,
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Wallentin L, Lopes RD, Hanna M, Thomas L, Hellkamp A, Nepal S, Hylek EM, Al-Khatib SM, Alexander JH, Alings M, Amerena J, Ansell J, Aylward P, Bartunek J, Commerford P, De Caterina R, Erol C, Harjola VP, Held C, Horowitz JD, Huber K, Husted S, Keltai M, Lanas F, Lisheng L, McMurray JJ, Oh BH, Rosenqvist M, Ruzyllo W, Steg PG, Vinereanu D, Xavier D, Granger CB. Efficacy and Safety of Apixaban Compared With Warfarin at Different Levels of Predicted International Normalized Ratio Control for Stroke Prevention in Atrial Fibrillation. Circulation 2013; 127:2166-76. [DOI: 10.1161/circulationaha.112.142158] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
In the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial, apixaban compared with warfarin reduced stroke and systemic embolism, major bleeding, and mortality. We evaluated treatment effects in relation to 2 predictions of time in therapeutic range (TTR).
Methods and Results—
The trial randomized 18 201 patients with atrial fibrillation to apixaban 5 mg twice daily or warfarin for at least 12 months. For each patient, a center average TTR was estimated with the use of a linear mixed model on the basis of the real TTRs in its warfarin-treated patients, with a fixed effect for country and random effect for center. For each patient, an individual TTR was also predicted with the use of a linear mixed effects model including patient characteristics as well. Median center average TTR was 66% (interquartile limits, 61% and 71%). Rates of stroke or systemic embolism, major bleeding, and mortality were consistently lower with apixaban than with warfarin across center average TTR and individual TTR quartiles. In the lowest and highest center average TTR quartiles, hazard ratios for stroke or systemic embolism were 0.73 (95% confidence interval [CI], 0.53–1.00) and 0.88 (95% CI, 0.57–1.35) (
P
interaction
=0.078), for mortality were 0.91 (95% CI, 0.74–1.13) and 0.91 (95% CI, 0.71–1.16) (
P
interaction
=0.34), and for major bleeding were 0.50 (95% CI, 0.36–0.70) and 0.75 (95% CI, 0.58–0.97) (
P
interaction
=0.095), respectively. Similar results were seen for quartiles of individual TTR.
Conclusions—
The benefits of apixaban compared with warfarin for stroke or systemic embolism, bleeding, and mortality appear similar across the range of centers’ and patients’ predicted quality of international normalized ratio control.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00412984.
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Affiliation(s)
- Lars Wallentin
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Renato D. Lopes
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Michael Hanna
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Laine Thomas
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Anne Hellkamp
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Sunil Nepal
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Elaine M. Hylek
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Sana M. Al-Khatib
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - John H. Alexander
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Marco Alings
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - John Amerena
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Jack Ansell
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Philip Aylward
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Jozef Bartunek
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Patrick Commerford
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Raffaele De Caterina
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Cetin Erol
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Veli-Pekka Harjola
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Claes Held
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - John D. Horowitz
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Kurt Huber
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Steen Husted
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Matyas Keltai
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Fernando Lanas
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Liu Lisheng
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - John J.V. McMurray
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Byung-Hee Oh
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Mårten Rosenqvist
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Witold Ruzyllo
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Philippe Gabriel Steg
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Dragos Vinereanu
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Denis Xavier
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
| | - Christopher B. Granger
- From the Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (L.W., C.H.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L., L.T., A.H., S.M.A.-K., J.H.A., C.B.G.); Bristol-Myers Squibb, Princeton, NJ (M.H.); Novartis Pharmaceuticals, Florham Park, NJ (S.N.); Boston University Medical Center, Boston, MA (E.M.H.); Working Group on Cardiovascular Research the Netherlands, Utrecht, Netherlands (M.A.)
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Ezekowitz JA, Bakal JA, Westerhout CM, Giugliano RP, White H, Keltai M, Prabhakaran D, Tricoci P, Van de Werf F, Califf RM, Newby LK, Armstrong PW. The relationship between meteorological conditions and index acute coronary events in a global clinical trial. Int J Cardiol 2013; 168:2315-21. [PMID: 23416014 DOI: 10.1016/j.ijcard.2013.01.061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 01/18/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Considerable uncertainty exists concerning the interaction between climate and human health. We explored this issue by evaluating the relationship between meteorological events and acute coronary syndrome (ACS) events. METHODS 9406 patients in 29 countries at 440 Early versus Delayed, Provisional Eptifibatide in Acute Coronary Syndromes (EARLY ACS) clinical trial sites were linked to a weather station by location. Temperature, barometric pressure, precipitation, wind speed and combined temperature and relative humidity were normalized by location for the 37 days prior to the index ACS event that precipitated study enrollment. A meteorological event was defined as a change in any weather metric that was expected to occur in less than 10% of the exposure intervals: four separate 48-hour intervals within the seven days prior to an ACS event (T1, day of event and -1 day; T2, -2 to -3 days; T3, -4 to -5 days; and T4, -6 to -7 days). Results are reported as ratio of observed to expected events for the meteorological parameter. RESULTS There were 10% more drops in temperature observed in T4 (95%CI: 3-17%), and more increases in temperature observed during T1 (4%; 95%CI -2-9%). An excess number of wind speed increases (9%;95%CI 2-16%) and relative humidity increases (6%; 95%CI 0.1-14%) occurred during T4. Additionally, female patients in this cohort presented less often than male patients following drops in average temperature. CONCLUSIONS Using a new method for integrating meteorological data into a clinical trial dataset, we identified associations between changes in weather conditions and the likelihood of an ACS event.
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Affiliation(s)
- Justin A Ezekowitz
- Division of Cardiology, Department of Medicine, University of Alberta, Alberta, Canada; Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.
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49
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Hohnloser SH, Hijazi Z, Thomas L, Alexander JH, Amerena J, Hanna M, Keltai M, Lanas F, Lopes RD, Lopez-Sendon J, Granger CB, Wallentin L. Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atrial fibrillation: insights from the ARISTOTLE trial. Eur Heart J 2012; 33:2821-30. [PMID: 22933567 DOI: 10.1093/eurheartj/ehs274] [Citation(s) in RCA: 389] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIMS Atrial fibrillation (AF) is common among patients with impaired renal function. Apixaban, a novel oral anticoagulant with partial renal excretion, was compared with warfarin and reduced the rate stroke, death and bleeding in the ARISTOTLE trial. We evaluated these outcomes in relation to renal function. METHODS AND RESULTS Baseline glomerular filtration rate (GFR) was estimated using the Cockcroft-Gault and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations as well as cystatin C measurements. According to baseline Cockcroft-Gault, there were 7518 patients (42%) with an estimated GFR (eGFR) of >80 mL/min, 7587 (42%) between >50 and 80 mL/min, and 3017 (15%) with an eGFR of ≤50 mL/min. The rate of cardiovascular events and bleeding was higher at impaired renal function (≤80 mL/min). Apixaban was more effective than warfarin in preventing stroke or systemic embolism and reducing mortality irrespective of renal function. These results were consistent, regardless of methods for GFR estimation. Apixaban was associated with less major bleeding events across all ranges of eGFRs. The relative risk reduction in major bleeding was greater in patients with an eGFR of ≤50 mL/min using Cockcroft-Gault {hazard ratio (HR) 0.50 [95% confidence interval (CI) 0.38-0.66], interaction P = 0.005} or CKD-EPI equations [HR 0.48 (95% CI 0.37-0.64), interaction P = 0.003]. CONCLUSION In patients with AF, renal impairment was associated with increased risk of cardiovascular events and bleeding. When compared with warfarin, apixaban treatment reduced the rate of stroke, death, and major bleeding, regardless of renal function. Patients with impaired renal function seemed to have the greatest reduction in major bleeding with apixaban.
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Affiliation(s)
- Stefan H Hohnloser
- Division of Clinical Electrophysiology, Department of Cardiology, J. W. Goethe University, Theodor-Stern-Kai 7, Frankfurt D 60590, Germany.
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James SK, Storey RF, Khurmi NS, Husted S, Keltai M, Mahaffey KW, Maya J, Morais J, Lopes RD, Nicolau JC, Pais P, Raev D, Lopez-Sendon JL, Stevens SR, Becker RC. Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes and a History of Stroke or Transient Ischemic Attack. Circulation 2012; 125:2914-21. [PMID: 22572911 DOI: 10.1161/circulationaha.111.082727] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Patients with acute coronary syndromes and history of stroke or transient ischemic attack (TIA) have an increased rate of recurrent cardiac events and intracranial hemorrhages.
Methods and Results—
We evaluated treatment effects of ticagrelor versus clopidogrel in patients with acute coronary syndrome with and without a history of prior stroke or TIA in the PLATelet inhibition and patient Outcomes (PLATO) trial. Of the 18 624 randomized patients, 1152 (6.2%) had a history of stroke or TIA. Such patients had higher rates of myocardial infarction (11.5% versus 6.0%), death (10.5% versus 4.9%), stroke (3.4% versus 1.2%), and intracranial bleeding (0.8% versus 0.2%) than patients without prior stroke or TIA. Among patients with a history of stroke or TIA, the reduction of the primary composite outcome and total mortality at 1 year with ticagrelor versus clopidogrel was consistent with the overall trial results: 19.0% versus 20.8% (hazard ratio, 0.87; 95% confidence interval, 0.66–1.13; interaction
P
=0.84) and 7.9% versus 13.0% (hazard ratio, 0.62; 95% confidence interval, 0.42–0.91). The overall PLATO-defined bleeding rates were similar: 14.6% versus 14.9% (hazard ratio, 0.99; 95% confidence interval, 0.71–1.37), and intracranial bleeding occurred infrequently (4 versus 4 cases, respectively).
Conclusions—
Patients with acute coronary syndrome with a prior history of ischemic stroke or TIA had higher rates of clinical outcomes than patients without prior stroke or TIA. However, the efficacy and bleeding results of ticagrelor in these high-risk patients were consistent with the overall trial population, with a favorable clinical net benefit and associated impact on mortality.
Clinical Trial Registration—
URL:
http://www.clinicatrials.gov
. Unique identifier: NCT00391872.
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Affiliation(s)
- Stefan K. James
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Robert F. Storey
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Nardev S. Khurmi
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Steen Husted
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Matyas Keltai
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Kenneth W. Mahaffey
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Juan Maya
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Joao Morais
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Renato D. Lopes
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Jose C. Nicolau
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Prem Pais
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Dimitar Raev
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Jose L. Lopez-Sendon
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Susanna R. Stevens
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
| | - Richard C. Becker
- From the Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (S.K.J.); Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom (R.F.S.); AstraZeneca Research & Development, Wilmington, DE (N.S.K., J. Maya); Department of Cardiology, Århus University Hospital, Århus, Denmark (S.H.); Semmelweis University, Hungarian Institute of Cardiology, Budapest, Hungary (M.K.); Duke Clinical Research Institute, Durham, NC (K
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